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研究人乳头瘤病毒(HPV)疫苗接种与偏头痛之间的可能关联:荷兰一项队列研究的结果

Examining a possible association between human papilloma virus (HPV) vaccination and migraine: results of a cohort study in the Netherlands.

作者信息

Schurink-Van't Klooster T M, de Ridder M A J, Kemmeren J M, van der Lei J, Dekker F, Sturkenboom M, de Melker H E

机构信息

Department National Immunisation Programme, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, PO box 1, 3720 BA, Bilthoven, The Netherlands,

出版信息

Eur J Pediatr. 2015 May;174(5):641-9. doi: 10.1007/s00431-014-2444-x. Epub 2014 Nov 1.

Abstract

UNLABELLED

Since the introduction of the bivalent human papilloma virus (HPV) vaccine in the Netherlands, migraine has been reported as a notable event in the passive safety surveillance system. Research on the association between HPV vaccination and migraine is needed. Therefore, potential migraine cases in 2008-2010 were selected from a group of general practitioners and linked to the vaccination registry. Data were analysed in three ways: (i) incidences of migraine postvaccination (2009/2010) were compared to pre-vaccination incidences (2008); (ii) in a cohort, incidence rates of migraine in vaccinated and unvaccinated girls were compared and (iii) in a self-controlled case series analysis, the relative incidence of migraine in potentially high-risk periods was compared to non-high-risk periods. Incidence rates of migraine for 12- to 16-year-old girls and boys postvaccination were slightly higher than pre-vaccination incidence rates. Incidence rate ratios (IRRs) for vaccinated compared to unvaccinated girls were not statistically significantly higher. Furthermore, the RR for migraine in the high-risk period of 6 weeks following each dose versus non-high-risk period was 4.3 (95% confidence interval (CI) 0.69-26.6) for certain migraine.

CONCLUSION

Using different methods, no statistically significant association between HPV vaccination and incident migraine was found. However, the number of cases was low; to definitively exclude the risk, an increased sample size is needed.

摘要

未标注

自二价人乳头瘤病毒(HPV)疫苗在荷兰引入以来,偏头痛在被动安全监测系统中被报告为一个显著事件。需要对HPV疫苗接种与偏头痛之间的关联进行研究。因此,从一组全科医生中选取了2008 - 2010年的潜在偏头痛病例,并与疫苗接种登记处进行关联。数据采用三种方式进行分析:(i)将接种疫苗后(2009/2010年)的偏头痛发病率与接种疫苗前(2008年)的发病率进行比较;(ii)在一个队列中,比较接种疫苗和未接种疫苗女孩的偏头痛发病率;(iii)在一个自我对照病例系列分析中,比较潜在高风险期与非高风险期偏头痛的相对发病率。接种疫苗后12至16岁女孩和男孩的偏头痛发病率略高于接种疫苗前的发病率。接种疫苗女孩与未接种疫苗女孩的发病率比(IRR)在统计学上没有显著更高。此外,对于特定偏头痛,每剂疫苗接种后6周的高风险期与非高风险期的RR为4.3(95%置信区间(CI)0.69 - 26.6)。

结论

使用不同方法,未发现HPV疫苗接种与新发偏头痛之间存在统计学上的显著关联。然而,病例数量较少;为明确排除风险,需要增加样本量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/594b/4412283/989cfc9e3ffc/431_2014_2444_Fig1_HTML.jpg

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