Injection Site and Risk of Medically Attended Local Reactions to Acellular Pertussis Vaccine
Injection Site and Risk of Medically Attended Local Reactions to Acellular Pertussis Vaccine
复制标题
DOI：
10.1542/peds.2010-1886
复制
发表时间：
2011-03-01
期刊：
影响因子：
8
通讯作者：
Baggs, James
中科院分区：
文献类型：
--
作者：
Jackson, Lisa A.;Yu, Onchee;Baggs, James
目的：为了评估是否有风险的医疗参加的局部反应的第五剂白喉和破伤风类毒素和无细胞百日咳（DTaP）疫苗根据注射部位（手臂与大腿）不同。方法：我们进行了一项回顾性队列研究的儿童年龄4至6岁的疫苗安全数据链人口谁收到了DTaP疫苗接种期间，从2002年至2006年。医疗参加的局部反应的DTaP疫苗被推定确定从行政数据，并确认了病历review.Results：在233 616名儿童的研究人群中，1017（0.4%）有一个确认的医疗参加的局部反应的第五剂DTaP疫苗。在臂部接种疫苗的这些反应的发生率（每10000次接种中有47.4例）显著高于在大腿接种疫苗的发生率（每10000次接种中有32.1例）（P <0.001）。在一项调整了年龄、性别和研究地点的多变量分析中，在手臂上接种疫苗的儿童发生局部反应的风险高出78（相对危险度：1.78 [95%置信区间：1.43-2.21]）。对第五剂DTaP疫苗的局部反应需要医学评估的情况并不常见，但是当疫苗注射在手臂上时，这些反应的风险明显更高。2这些发现表明，大腿应该被认为是这种疫苗接种的可接受的注射部位。儿科2011;127：e581-e587
OBJECTIVE: To assess whether the risk of medically attended local reactions to the fifth dose of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine varies according to injection site (arm versus thigh).METHODS: We conducted a retrospective cohort study of children aged 4 through 6 years in the Vaccine Safety Datalink population who received a DTaP vaccination during the period from 2002 through 2006. Medically attended local reactions to the DTaP vaccine were presumptively identified from administrative data and were confirmed by medical record review.RESULTS: Among the 233 616 children in the study population, 1017 (0.4%) had a confirmed medically attended local reaction to the fifth dose of the DTaP vaccine. The rate of those reactions was significantly higher with vaccinations given in the arm (47.4 per 10 000 vaccinations) compared with vaccinations given in the thigh (32.1 per 10 000 vaccinations) (P < .001). In a multivariable analysis adjusted for age, gender, and study site, children vaccinated in the arm had a 78% higher risk of a local reaction (relative risk: 1.78 [95% confidence interval: 1.43-2.21]).CONCLUSIONS: Local reactions to the fifth dose of the DTaP vaccine that require medical evaluation are uncommon, but the risk of those reactions is significantly higher when the vaccine is injected in the arm. These findings suggest that the thigh should be considered as an acceptable site of injection for this vaccination. Pediatrics 2011;127: e581-e587