Anaphylaxis after vaccination reported to the Vaccine Adverse Event Reporting System, 1990-2016
Anaphylaxis after vaccination reported to the Vaccine Adverse Event Reporting System, 1990-2016
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DOI：
10.1016/j.jaci.2018.12.1003
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发表时间：
2019-04-01
影响因子：
14.2
通讯作者：
Cano, Maria V.
中科院分区：
文献类型：
--
作者：
Su, John R.;Moro, Pedro L.;Cano, Maria V.
背景：过敏反应是一种罕见且可能危及生命的过敏反应，可在接种疫苗后发生。目的：我们试图描述1990-2016年期间疫苗不良事件报告系统（VAERS）接种疫苗后过敏反应的报告。方法：我们使用管理活动查询医学词典和首选术语的组合来确定VAERS中过敏反应的国内报告。我们进行了描述性分析，包括过敏史（过敏反应、呼吸道过敏和药物过敏）和接种疫苗。我们回顾了所有严重报告和所有有医疗记录的非严重报告，以确定他们是否符合布莱顿合作对过敏反应的病例定义或接受了医生的诊断。结果：分析期内，VAERS共收到报告467960份；828例符合布莱顿合作病例定义或接受医生诊断为过敏反应：654例（79%）被分类为严重，669例（81%）有医疗记录。在478例19岁以下儿童报告中，65%为男性；儿童疫苗是最常见的报告。在350例19岁或以上的报告中，80%为女性，流感疫苗是最常见的报告。总的来说，41%的报告描述了没有过敏史的人。我们确定了8例死亡，其中4例无过敏史。结论：疫苗接种后的过敏反应在美国是罕见的，可以发生在没有过敏史的人。大多数人经治疗完全康复，但可能发生严重并发症，包括死亡。
Background: Anaphylaxis, a rare and potentially life-threatening hypersensitivity reaction, can occur after vaccination.Objective: We sought to describe reports of anaphylaxis after vaccination made to the Vaccine Adverse Event Reporting System (VAERS) during 1990-2016.Methods: We identified domestic reports of anaphylaxis within VAERS using a combination of Medical Dictionary for Regulatory Activity queries and Preferred Terms. We performed a descriptive analysis, including history of hypersensitivity (anaphylaxis, respiratory allergies, and drug allergies) and vaccines given. We reviewed all serious reports and all nonserious reports with available medical records to determine if they met the Brighton Collaboration case definition for anaphylaxis or received a physician's diagnosis.Results: During the analytic period, VAERS received 467,960 total reports; 828 met the Brighton Collaboration case definition or received a physician's diagnosis of anaphylaxis: 654 (79%) were classified as serious, and 669 (81%) had medical records available. Of 478 reports in children aged less than 19 years, 65% were male; childhood vaccines were most commonly reported. Of 350 reports in persons aged 19 years or greater, 80% were female, and influenza vaccines were most frequently reported. Overall, 41% of reports described persons with no history of hypersensitivity. We identified 8 deaths, 4 among persons with no history of hypersensitivity.Conclusion: Anaphylaxis after vaccination is rare in the United States and can occur among persons with no history of hypersensitivity. Most persons recover fully with treatment, but serious complications, including death, can occur.