麻疹と pertussisの個人およびコミュニティのリスクは,免疫への個人的な免除と関連しています
D R Feikin1, D C Lezotte, R F Hamman
1Respiratory Diseases Branch, Centers for Disease Control and Prevention, 1600 Clifton Rd, MS-C23, Atlanta, GA 30333, USA. drf0@cdc.gov
JAMA
|January 3, 2001
まとめ
ワクチンの個人免除を受けた子供は,麻疹や pertussis のリスクが高くなります. これらの未ワクチン接種の子どもたちは,また,地域社会での病気の拡散を増加させ,ワクチン接種を受けた個人に影響を及ぼします.
科学分野:
- エピデミオロジー エピデミオロジー
- 公衆衛生は公衆衛生である.
- 予防接種に関する研究
背景:
- 哲学的または宗教的免疫免除の子供におけるワクチンで予防可能な病気のリスクはよく理解されていません.
- ワクチンの免除を受けた研究不足の集団は,公衆衛生上の潜在的な課題を提示します.
研究 の 目的:
- 個人免疫免除が,個人レベルとコミュニティレベルの両方で,麻疹と pertussis のリスクの増加と関連しているかどうかを決定する.
- ワクチンの免除が病気の伝染に与える影響を評価する.
主な方法:
- コロラド州で1987年から1998年のデータを用いて,人口ベースの遡及的なコホート研究が行われました.
- 分析には,3歳から18歳の子どもで報告された麻疹と pertussis の症例が含まれました.
- 重要な指標は,相対リスクの計算と,免除率と疾患発生率の関連性でした.
主要な成果:
- 個人の免除を受けた子供は,ワクチン接種を受けた子供と比較して,麻疹 (22.2倍) と pertussis (5.9倍) を罹患する可能性が著しく高かった.
- 郡での免除率の上昇は,ワクチン接種を受けた子供における麻疹と pertussis の発生率の増加と相関しています.
- pertussis 発症した学校では,不発症の学校よりも,不発症者の割合が高かった (4.3%).
結論:
- 個人の予防接種の免除は,麻疹と pertussisの実質的に高いリスクと関連しています.
- 公共衛生担当者は,コミュニティ疾病の発生における例外の役割を考慮する必要があります.
- ワクチン接種拒否に伴うリスクについて親に知らせることは,公衆衛生にとって極めて重要です.
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