The authors evaluated the association between receipt of measles-mumps-rubella (MMR) vaccine and asthma-like disease in early childhood in a Danish nationwide cohort study (N = 871,234). Two outcomes were included: hospitalizations with asthma diagnoses and use of anti-asthma medications (for a subset of the cohort only). Poisson regression was used to estimate rate ratios according to vaccination status. MMR-vaccinated children were less often hospitalized with an asthma diagnosis (rate ratio (RR) = 0.75, 95% confidence interval (CI): 0.73, 0.78) and used fewer courses of anti-asthma medication (RR = 0.92, 95% CI: 0.91, 0.92) than unvaccinated children. This "protective" effect of MMR vaccine was more pronounced for hospitalizations with severe asthma diagnoses (status asthmaticus: RR = 0.63, 95% CI: 0.49, 0.82) and use of medication that was highly specific for asthma (long-acting beta2-agonist inhalant: RR = 0.68, 95% CI: 0.63, 0.73). MMR vaccine was not negatively associated with anti-asthma medications often used for wheezing illnesses in early childhood (systemic beta2-agonist: RR = 1.02, 95% CI: 1.01, 1.02). These results are compatible not with an increased risk of asthma following MMR vaccination but rather with the hypothesis that MMR vaccination is associated with a reduced risk of asthma-like disease in young children.

译文

作者在丹麦的一项全国队列研究 (N = 871,234) 中评估了麻疹-腮腺炎-风疹 (MMR) 疫苗接种与儿童早期哮喘样疾病之间的关系。包括两个结果: 诊断为哮喘的住院治疗和使用抗哮喘药物 (仅针对该队列的一个子集)。泊松回归用于根据疫苗接种状况估计比率。与未接种疫苗的儿童相比,接种MMR的儿童因哮喘诊断而住院的频率较低 (率比 (RR) = 0.75,95% 置信区间 (CI): 0.73,0.78),使用抗哮喘药物的疗程较少 (RR = 0.92,95% CI: 0.91,0.92)。MMR疫苗的这种 “保护” 作用对于严重哮喘诊断 (哮喘状态: RR = 0.63,95% CI: 0.49,0.82) 和使用对哮喘具有高度特异性的药物 (长效beta2-agonist吸入剂: RR = 0.68,95% CI: 0.63,0.73)。MMR疫苗与儿童早期经常用于喘息疾病的抗哮喘药物没有负相关 (系统beta2-agonist: RR = 1.02,95% CI: 1.01,1.02)。这些结果与MMR疫苗接种后哮喘风险增加不一致,而是与MMR疫苗接种与幼儿哮喘样疾病风险降低相关的假设一致。

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