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首页> 外文期刊>Vaccine >High-dose vitamin A supplementation administered with vaccinations after 6 months of age: sex-differential adverse reactions and morbidity.
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High-dose vitamin A supplementation administered with vaccinations after 6 months of age: sex-differential adverse reactions and morbidity.

机译：大剂量维生素A补充剂在6个月大后接种疫苗：性别差异的不良反应和发病率。

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Background: WHO recommends vitamin A supplementation (VAS) at vaccination contacts after six months of age. The effect of this recommendation on mortality has not been evaluated. Methods: We tested the effect of VAS at vaccination contacts on mortality in a randomised trial in Guinea-Bissau. In a subgroup within this trial we studied adverse reactions to VAS and whether VAS modified known adverse reactions to live and inactivated vaccines and general morbidity during the first month after supplementation overall and by sex. Children aged 6-17 months were randomised to VAS or placebo at the day of vaccination (day 0). We interviewed the caretaker, assessed the fontanel and measured temperature and local reaction at the injection site at home visits on day 1, 2, 3, 7, 14, 21, and 31. We defined systemic adverse reactions to inactivated and live vaccines as fever on day 1 and 2 and on 4-14 respectively. Clinical symptoms associated with increased intracranial pressure (ICP) on day 1 were considered possible adverse reactions to VAS. Results: In 1673 children VAS had no overall effect on clinical symptoms associated with increased ICP (Relative Risk(RR)=1.07 (95%CI: 0.85-1.35)). However, VAS was associated with such clinical symptoms in boys RR=1.38 (1.00-1.91) but not in girls (p=0.03 for interaction between VAS and sex). VAS had no effect on fever after inactivated vaccines. VAS had no overall effect on fever after live vaccines (RR=0.86 (0.53-1.39)), but tended to reduce the prevalence of fever in boys (RR=0.58 (0.30-1.14)), but not in girls (RR=1.37 (0.66-2.84)) (p=0.09 for interaction between VAS and sex). VAS was associated with increased local reactions to measles vaccine in both sexes (RR=3.65 (1.20-11.12)). Conclusion: Adverse reactions were rare, mild and transient and may not in their own right cause concern. However, VAS caused sex-differential adverse reactions and may have sex-differential effects on adverse reactions to vaccines.
机译：背景：世卫组织建议六个月大的婴儿在接种疫苗后补充维生素A（VAS）。该建议对死亡率的影响尚未评估。方法：我们在几内亚比绍的一项随机试验中，测试了接种疫苗后VAS对死亡率的影响。在该试验的一个亚组中，我们研究了对VAS的不良反应，以及在整体和性别补充后的第一个月内，VAS是否改变了已知的对活疫苗和灭活疫苗的不良反应以及一般发病率。 6-17个月大的儿童在接种当天（第0天）被随机分配到VAS或安慰剂中。我们在第1、2、3、7、14、21和31天的家访中采访了看管人，评估了an门并测量了注射部位的温度和局部反应。我们将灭活和活疫苗的全身不良反应定义为发烧分别在第1天和第2天以及第4-14天。与第1天颅内压（ICP）升高相关的临床症状被认为可能是对VAS的不良反应。结果：在1673名儿童中，VAS对与ICP升高相关的临床症状没有总体影响（相对风险（RR）= 1.07（95％CI：0.85-1.35））。但是，VAS与男孩RR = 1.38（1.00-1.91）的这种临床症状相关，而与女孩无关（对于VAS与性别之间的相互作用p = 0.03）。灭活疫苗后，VAS对发烧没有影响。活疫苗接种后，VAS对发烧没有总体影响（RR = 0.86（0.53-1.39）），但倾向于降低男孩发烧的流行率（RR = 0.58（0.30-1.14）），但对女孩发烧没有影响（RR = 1.37） （0.66-2.84））（对于VAS和性别之间的互动，p = 0.09）。 VAS与男女对麻疹疫苗的局部反应增加有关（RR = 3.65（1.20-11.12））。结论：不良反应少见，轻度和短暂，可能不会引起人们的关注。但是，VAS会引起性别差异性不良反应，并且可能会对疫苗的不良反应产生性别差异性影响。

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