Pediatrics. 2014 Aug;134(2):325-337. Epub 2014 Jul 1.
Sécurité des vaccins utilisés pour la vaccination de routine des enfants américains: un examen systématique
Maglione MA1, Das L2, Raaen L2, Smith A2, Chari R2, Newberry S2, Shanman R2, Perry T2, Goetz MB3, Gidengil C4.
- 1RAND Corporation, Santa Monica, California; maglione@rand.org
- 2RAND Corporation, Santa Monica, California;
- 3VA Greater Los Angeles Healthcare System and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; and.
- 4RAND Corporation, Santa Monica, California;Boston Children's Hospital, Boston, Massachusetts.
Abstract
BACKGROUND:
Concerns about vaccine safety have led some parents to decline recommended vaccination of their children, leading to the resurgence of diseases. Reassurance of vaccine safety remains critical for population health. This study systematically reviewed the literature on the safety of routine vaccines recommended for children in the United States.
Les préoccupations concernant la sécurité des vaccins ont conduit certains parents à refuser la vaccination recommandée de leurs enfants, ce qui conduit à la résurgence de maladies. L'assurance de l'innocuité des vaccins demeure critique pour la santé de la population. Cette étude passe systématiquement en revue la littérature sur la sécurité des vaccins de routine recommandées pour les enfants aux États-Unis. METHODS:
Data sources included PubMed, Advisory Committee on Immunization Practices statements, package inserts, existing reviews, manufacturer information packets, and the 2011 Institute of Medicine consensus report on vaccine safety. We augmented the Institute of Medicine report with more recent studies and increased the scope to include more vaccines. Only studies that used active surveillance and had a control mechanism were included. Formulations not used in the United States were excluded. Adverse events and patient and vaccine characteristics were abstracted. Adverse event collection and reporting was evaluated by using the McHarm scale. We were unable to pool results. Strength of evidence was rated as high, moderate, low, or insufficient.
RESULTS:
Of 20 478 titles identified, 67 were included. Strength of evidence was high for measles/mumps/rubella (MMR) vaccine and febrile seizures; the varicella vaccine was associated with complications in immunodeficient individuals. There is strong evidence that MMR vaccine is not associated with autism. There is moderate evidence that rotavirus vaccines are associated with intussusception. Limitations of the study include that the majority of studies did not investigate or identify risk factors for AEs; and the severity of AEs was inconsistently reported.
Des 20 478 titres recensés, 67 ont été inclus. Les preuves étaient très fortes pour rougeole/oreillons/rubéole (ROR) et les convulsions fébriles; le vaccin contre la varicelle a été associée à des complications chez les personnes immunodéprimés. Il existe des preuves solides que le vaccin ROR n'est pas associé à l'autisme. Il existe une preuve modérée que les vaccins antirotavirus sont associés à une invagination intestinale. Les limites de l'étude comprennent que la majorité des études n'a pas enquêté ou identifier les facteurs de risque pour les effets indésirables ; et la gravité des effets indésirables a été rapporté de manière incompatible. CONCLUSIONS:
We found evidence that some vaccines are associated with serious AEs; however, these events are extremely rare and must be weighed against the protective benefits that vaccines provide.
Nous avons constaté que certains vaccins sont associées à des effets indésirables graves; Cependant, ces événements sont extrêmement rares et doivent être pesés en regard des avantages de protection que les vaccins procurent.
Copyright © 2014 by the American Academy of Pediatrics.
- PMID:
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