Timely Versus Delayed Early Childhood Vaccination and Seizures
Timely Versus Delayed Early Childhood Vaccination and Seizures
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DOI：
10.1542/peds.2013-3429
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发表时间：
2014-06-01
期刊：
影响因子：
8
通讯作者：
DeStefano, Frank
中科院分区：
文献类型：
--
作者：
Hambidge, Simon J.;Newcomer, Sophia R.;DeStefano, Frank
背景：对于儿童疫苗接种的时间和疫苗接种后癫痫发作知之甚少。方法：在来自疫苗安全数据链的 2004 年至 2008 年出生的 323 247 名美国儿童队列中，我们通过对生命前 2 年内接受的第一剂个别疫苗的自我对照病例系列分析，分析了儿童疫苗接种时间与首次癫痫发作之间的关联。结果：在婴儿中，疫苗接种时间与首次癫痫发作之间的关联性。婴儿疫苗接种和疫苗接种后癫痫发作。在生命的第二年，在 12 至 15 个月内接受第一剂麻疹-腮腺炎-风疹疫苗 (MMR) 后癫痫发作的发生率比 (IRR) 为 2.65（95% 置信区间 [CI] 1.99-3.55）； 16 至 23 个月 MMR 剂量后的 IRR 为 6.53 (95% CI 3.15-13.53)。在 12 至 15 个月内接受第一剂麻疹-腮腺炎-风疹-水痘疫苗 (MMRV) 后癫痫发作的 IRR 为 4.95 (95% CI 3.68-6.66)； 16 至 23 个月时接种 MMRV 后的 IRR 为 9.80 (95% CI 4.35-22.06)。 结论：无论接种时间如何，婴儿接种后癫痫发作的风险均不会增加。在第 2 年，延迟接种 MMR 疫苗超过 15 个月会导致癫痫发作的风险更高。 MMRV 疫苗使这种关联的强度加倍。这些研究结果表明，在癫痫发作方面，按时接种疫苗与出生后第一年延迟接种疫苗一样安全，并且与按时接种疫苗相比，出生后第二年延迟接种疫苗与更多的疫苗接种后癫痫发作相关。
BACKGROUND: Little is known regarding the timing of childhood vaccination and postvaccination seizures.METHODS: In a cohort of 323 247 US children from the Vaccine Safety Datalink born from 2004 to 2008, we analyzed the association between the timing of childhood vaccination and the first occurrence of seizure with a self-controlled case series analysis of the first doses of individual vaccines received in the first 2 years of life.RESULTS: In infants, there was no association between the timing of infant vaccination and postvaccination seizures. In the second year of life, the incident rate ratio (IRR) for seizures after receipt of the first measles-mumps-rubella vaccine (MMR) dose at 12 to 15 months was 2.65 (95% confidence interval [CI] 1.99-3.55); the IRR after an MMR dose at 16 to 23 months was 6.53 (95% CI 3.15-13.53). The IRR for seizures after receipt of the first measles-mumps-rubella-varicella vaccine (MMRV) dose at 12 to 15 months was 4.95 (95% CI 3.68-6.66); the IRR after an MMRV dose at 16 to 23 months was 9.80 (95% CI 4.35-22.06).CONCLUSIONS: There is no increased risk of postvaccination seizure in infants regardless of timing of vaccination. In year 2, delaying MMR vaccine past 15 months of age results in a higher risk of seizures. The strength of the association is doubled with MMRV vaccine. These findings suggest that on-time vaccination is as safe with regard to seizures as delayed vaccination in the first year of life, and that delayed vaccination in the second year of life is associated with more postvaccination seizures than on-time vaccination.