Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States: A Review of Measles and Pertussis.
Association Between Vaccine Refusal and Vaccine-Preventable Diseases in the United States: A Review of Measles and Pertussis.
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DOI：
10.1001/jama.2016.1353
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发表时间：
2016-03-15
影响因子：
120.7
通讯作者：
Omer, Saad B.
中科院分区：
文献类型：
--
作者：
Phadke, Varun K.;Bednarczyk, Robert A.;Salmon, Daniel A.;Omer, Saad B.
犹豫是否要给孩子接种疫苗的父母可能会推迟常规免疫接种或寻求州疫苗强制规定的豁免。最近美国爆发的疫苗可预防疾病引起了人们对这一现象的关注。需要更好地了解拒绝接种疫苗与这些疾病的流行病学之间的关联。回顾已发表的文献，评估延迟、拒绝或豁免疫苗接种与麻疹和百日咳这两种美国最近爆发的疫苗可预防疾病的流行病学之间的关系。检索截至 2015 年 11 月 30 日的 PubMed，查找自美国宣布消除麻疹（2000 年 1 月 1 日之后）以来美国麻疹疫情的报告、自美国百日咳发病最低点（1977 年 1 月 1 日之后）以来发生的地方性和流行性百日咳的报告，以及在疫苗延迟或豁免的情况下评估疾病风险的研究。我们确定了 18 项已发表的麻疹研究（9 份年度摘要和 9 份疫情报告），其中描述了 1416 例麻疹病例（个体年龄范围，2 周至 84 岁；178 例病例小于 12 个月），超过一半 (56.8%) 没有麻疹疫苗接种史。在有详细疫苗接种数据的 970 例麻疹病例中，有 574 例尽管符合疫苗资格但未接种疫苗，其中 405 例（70.6%）有非医疗豁免（例如，出于宗教或哲学原因的豁免，而不是医疗禁忌；占总数的 41.8%）。在 32 份百日咳疫情报告中，包括 10 609 名报告了疫苗接种状况的个人（年龄范围，10 天至 87 岁），5 个最大的全州流行病中有很大比例（范围，24%–45%）未接种疫苗或疫苗接种不足的个人。然而，在高度接种疫苗的人群中也发生了几次百日咳疫情，表明免疫力下降。九份报告（描述了 12 起疫情）提供了未免疫病例的详细疫苗接种数据；在其中 8 次疫情中，59% 到 93% 的未接种疫苗的个体是故意不接种疫苗的。在消除麻疹后的时代，美国很大一部分麻疹病例是故意不接种疫苗的。拒绝接种疫苗的现象与拒绝接种疫苗的人和完全接种疫苗的人患麻疹的风险增加有关。尽管百日咳卷土重来是由于免疫力下降和其他因素造成的，但拒绝接种疫苗仍然与某些人群中百日咳风险增加有关。
Parents hesitant to vaccinate their children may delay routine immunizations or seek exemptions from state vaccine mandates. Recent outbreaks of vaccine-preventable diseases in the United States have drawn attention to this phenomenon. Improved understanding of the association between vaccine refusal and the epidemiology of these diseases is needed. To review the published literature to evaluate the association between vaccine delay, refusal, or exemption and the epidemiology of measles and pertussis, 2 vaccine-preventable diseases with recent US outbreaks. Search of PubMed through November 30, 2015, for reports of US measles outbreaks that have occurred since measles was declared eliminated in the United States (after January 1, 2000), endemic and epidemic pertussis since the lowest point in US pertussis incidence (after January 1, 1977), and for studies that assessed disease risk in the context of vaccine delay or exemption. We identified 18 published measles studies (9 annual summaries and 9 outbreak reports), which described 1416 measles cases (individual age range, 2 weeks-84 years; 178 cases younger than 12 months) and more than half (56.8%) had no history of measles vaccination. Of the 970 measles cases with detailed vaccination data, 574 cases were unvaccinated despite being vaccine eligible and 405 (70.6%) of these had nonmedical exemptions (eg, exemptions for religious or philosophical reasons, as opposed to medical contraindications; 41.8%of total). Among 32 reports of pertussis outbreaks, which included 10 609 individuals for whom vaccination status was reported (age range, 10 days-87 years), the 5 largest statewide epidemics had substantial proportions (range, 24%–45%) of unvaccinated or undervaccinated individuals. However, several pertussis outbreaks also occurred in highly vaccinated populations, indicating waning immunity. Nine reports (describing 12 outbreaks) provided detailed vaccination data on unimmunized cases; among 8 of these outbreaks from 59%through 93%of unvaccinated individuals were intentionally unvaccinated. A substantial proportion of the US measles cases in the era after elimination were intentionally unvaccinated. The phenomenon of vaccine refusal was associated with an increased risk for measles among people who refuse vaccines and among fully vaccinated individuals. Although pertussis resurgence has been attributed to waning immunity and other factors, vaccine refusal was still associated with an increased risk for pertussis in some populations.
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影响因子：
5.1
作者：
BROOME, CV;PREBLUD, SR;FRASER, DW
通讯作者：
FRASER, DW
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158.5
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作者：
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通讯作者：
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6.4
作者：
BIELLIK, RJ;PATRIARCA, PA;DAVIS, JP
通讯作者：
DAVIS, JP