既得免疫不全症候群のリスクは,B型肝炎ワクチン接種を抑止すべきか? 決定分析とは,意思決定の分析である
JAMA
|December 28, 1984
まとめ
B型肝炎 (HB) ワクチン接種は,ワクチンによる獲得免疫不全症候群 (AIDS) のリスクを最小限に抑え,命を救います. HBワクチン接種を遅らせることは,潜在的な汚染に関する懸念がある場合でもお勧めしません.
科学分野:
- 公衆衛生は公衆衛生である.
- ワクチン学 ワクチン学
- エピデミオロジー エピデミオロジー
背景:
- B型肝炎ワクチンの獲得免疫不全症候群 (AIDS) への感染の恐れが広まっているため,ワクチン接種率が低下する可能性が高い.
- 2年以内に合成のB型肝炎ワクチンが利用可能になるため,現在進行中のワクチン接種を遅らせることを検討する人もいます.
研究 の 目的:
- B型肝炎の即時のワクチン接種と,将来の合成ワクチンのワクチン接種を遅らせることに関連した死亡リスクを比較する.
- B型肝炎およびワクチンによる潜在的獲得免疫不全症候群 (AIDS) による死亡リスクを評価する.
主な方法:
- リスクを比較するために,意思決定分析モデルが開発されました.
- このモデルでは,B型肝炎の感染の年間5%のリスクを持つ個人のアウトカムを評価した.
- B型肝炎の死亡率,ワクチンによるエイズ率,信頼区間に関する推定値が組み込まれました.
主要な成果:
- 緊急のB型肝炎ワクチン接種は,年間5%のB型肝炎のリスクを持つ10万人あたり25人の命を救うと推定されています.
- ワクチンによる獲得免疫不全症候群 (AIDS) の推定率はゼロです.
- ワクチンによるエイズの発生率は10万人に8人以下だと95%の確信がある.
結論:
- B型肝炎ワクチンの接種を延期することは,ワクチンが誘発した獲得免疫不全症候群 (AIDS) の割合が現在の推定値より大幅に高い場合を除き,推奨される個人に合理的とは考えられない.
- 緊急のB型肝炎ワクチン接種の利点は,ワクチンが誘発するAIDSの最小的,ほぼゼロのリスクを大幅に上回ります.
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