Myopericarditis following smallpox vaccination
Myopericarditis following smallpox vaccination
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DOI：
10.1093/aje/kwh269
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发表时间：
2004-10-01
影响因子：
5
通讯作者：
Tornberg, DN
中科院分区：
文献类型：
--
作者：
Arness, MK;Eckart, RE;Tornberg, DN
肌心包炎是接种纽约市卫生局牛痘病毒株（Dryvax; Wyeth Laboratories，Marietta，Pennsylvania）天花疫苗后的罕见或未被识别的事件。在这篇文章中，作者报告了每百万例初次接种天花疫苗中至少有140例心肌心包炎的可归因发病率。从2002年12月15日至2003年9月30日，在492，730名美国武装部队人员接种疫苗后，检测到58名男性和1名女性，年龄21-43岁，确诊或可能患有急性心肌心包炎。这些病例是通过向军事总部的哨点报告、使用国防医学监测系统的主动监测或向疫苗不良事件报告系统的报告确定的。观察到的发生率在347，516名初级疫苗接种者中，30天观察窗内的心肌心包炎发病率为16.11/100，000，比预期的2.16/100，000高出近7.5倍（95%置信区间：1.90，2.34），而145，155名再接种者与预期的背景率没有统计学差异。病例主要为男性（58/59; 98.3%）和白色（51/59; 86.4%），两者均具有统计学显著性相关性（分别为p = 0.0147和p = 0.05）。
Myopericarditis has been a rare or unrecognized event after smallpox vaccinations with the New York City Board of Health strain of vaccinia virus (Dryvax; Wyeth Laboratories, Marietta, Pennsylvania). In this article, the authors report an attributable incidence of at least 140 clinical cases of myopericarditis per million primary smallpox vaccinations with this strain of vaccinia virus. Fifty-eight males and one female aged 21-43 years with confirmed or probable acute myopericarditis were detected following vaccination of 492,730 US Armed Forces personnel from December 15, 2002, through September 30, 2003. The cases were identified through sentinel reporting to military headquarters, active surveillance using the Defense Medical Surveillance System, or reports to the Vaccine Adverse Event Reporting System. The observed incidence (16.11/100,000) of myopericarditis over a 30-day observation window among 347,516 primary vaccinees was nearly 7.5-fold higher than the expected rate of 2.16/100,000 (95% confidence interval: 1.90, 2.34) among nonvaccinated, active-duty military personnel, while the incidence of 2.07/100,000 among 145,155 revaccinees was not statistically different from the expected background rate. The cases were predominantly male (58/59; 98.3%) and White (51/59; 86.4%), both statistically significant associations (p = 0.0147 and p = 0.05, respectively).