Measles-Containing Vaccines and Febrile Seizures in Children Age 4 to 6 Years
Measles-Containing Vaccines and Febrile Seizures in Children Age 4 to 6 Years
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DOI：
10.1542/peds.2011-3198
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发表时间：
2012-05-01
期刊：
影响因子：
8
通讯作者：
Fireman, Bruce
中科院分区：
文献类型：
--
作者：
Klein, Nicola P.;Lewis, Edwin;Fireman, Bruce
背景技术：在美国，儿童接受两剂麻疹-腮腺炎-风疹疫苗（MMR）和水痘疫苗（V），第一剂在1至2岁之间，第二剂在4至6岁之间。在1至2岁的儿童中，MMRV后7至10天的热性惊厥风险是单独MMR + V后的两倍。MMRV或MMR + V是否会影响4至6岁儿童的热性惊厥风险尚未报道。在4至6岁的疫苗安全数据链成员中，我们确定了2000年至2008年急诊室和医院的癫痫发作，以及2006年至2008年7 - 10天和0 - 42天的发热门诊就诊结果：从2006年到2008年，86750名儿童接受了MMRV;从2000年到2008年，67438名儿童在同一天接受了MMR + V。MMRV后7 ~ 10天有1例热性惊厥，MMR + V后无。热性惊厥风险为1/86 750 MMRV剂量（95%置信区间，1/3 426 441，1/15 570）和0/67 438 MMR + V剂量结论：本研究再次证实MMRV和MMR + V与4- 6岁儿童热性惊厥风险增加无关。我们可以在95%的置信度下排除每15 500剂MMRV和每18 000剂MMR + V中发生1次以上发热性惊厥的风险。儿科2012;129：809-814
BACKGROUND: In the United States, children receive 2 doses of measles-mumps-rubella vaccine (MMR) and varicella vaccine (V), the first between ages 1 to 2 years and the second between ages 4 to 6 years. Among 1- to 2-year-olds, the risk of febrile seizures 7 to 10 days after MMRV is double that after separate MMR + V. Whether MMRV or MMR + V affects risk for febrile seizure risk among 4- to 6-year-olds has not been reported.METHODS: Among 4- to 6-year-old Vaccine Safety Datalink members, we identified seizures in the emergency department and hospital from 2000 to 2008 and outpatient visits for fever from 2006 to 2008 during days 7 to 10 and 0 to 42 after MMRV and MMR + V. Incorporating medical record reviews, we assessed seizure risk after MMRV and MMR + V.RESULTS: From 2006 through 2008, 86 750 children received MMRV; from 2000 through 2008, 67 438 received same-day MMR + V. Seizures were rare throughout days 0 to 42 without peaking during days 7 to 10. There was 1 febrile seizure 7 to 10 days after MMRV and 0 after MMR + V. Febrile seizure risk was 1 per 86 750 MMRV doses (95% confidence interval, 1 per 3 426 441, 1 per 15 570) and 0 per 67 438 MMR + V doses (1 per 18 282).CONCLUSIONS: This study provides reassurance that MMRV and MMR + V were not associated with increased risk of febrile seizures among 4- to 6-year-olds. We can rule out with 95% confidence a risk greater than 1 febrile seizure per 15 500 MMRV doses and 1 per 18 000 MMR + V doses. Pediatrics 2012;129:809-814