肿瘤存活儿童的疫苗接种实践和思考  

Practices and considerations for vaccination of children who survived cancer

作　　者：王中林[1] 王相诗[1] 王宏胜[1] 李凯[1] 周蓓华[1] 常海岭[1] 魏仲秋 翟晓文[1] 曾玫[1] Wang Zhonglin;Wang Xiangshi;Wang Hongsheng;Li Kai;Zhou Beihua;Chang Hailing;Wei Zhongqiu;Zhai Xiaowen;Zeng Mei(Children’s Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院,上海201102

出　　处：《中国疫苗和免疫》2021年第5期576-579,583,共5页Chinese Journal of Vaccines and Immunization

基　　金：上海市卫生和计划生育委员会科研课题(201540051)。

摘　　要：目的探讨肿瘤存活儿童的个体化预防接种。方法选择2017-2019年上海市某医院就诊的肿瘤存活儿童,对化疗结束后≥6个月、≥12月患儿分别推荐接种灭活疫苗、减毒活疫苗;对要求提早接种或未化疗的患儿,结合免疫功能评估后推荐接种疫苗;患儿均按照常规剂量接种,并随访接种后不良反应。结果共纳入肿瘤存活儿童231例,平均年龄为3.67±2.51岁(范围:0.17-16.10岁);其中血液系统恶性疾病46例(19.9%)、恶性实体瘤185例(80.1%);肿瘤治疗结束后时间为0-5月、6-11月、≥12月者分别占9.5%、26.0%、64.5%;免疫功能正常、异常、未检测者分别占60.6%、1.7%、37.7%。随访获得176例儿童疫苗接种信息,平均随访时间为23.5±8.8月,其中166例接种疫苗共1483剂次,不良反应发生率为1.3‰。结论肿瘤存活儿童的个体化疫苗接种推荐是可行和安全的。Objective To explore individualized vaccination recommendations for children who survived cancer.Methods We enrolled childhood cancer survivors who had been treated in a Shanghai hospital during 2017-2019.We recommended inactivated vaccines and attenuated live vaccines for children who had completed chemotherapy for≥6 and≥12 months,respectively.For children with early vaccination requests or who had not undergone chemotherapy,vaccination recommendations depended on evaluation of their immune function.All children were vaccinated with routinely used vaccines and observed for adverse reactions after vaccination.Results A total of 231 children who survived cancer were included;the mean age was 3.67±2.51 years(range:0.17-16.10 years).Among the children,46(19.9%)had malignant hematological diseases and 185(80.1%)had malignant solid tumors;9.5%,26.0%,and 64.5%of children had completed chemotherapy for 0-5,6-11,and≥12 months,respectively;60.6%,1.7%,and 37.7%of children’s immune function was normal,abnormal,and not assessed.Vaccination information was obtained from 176 children with an average follow-up time of 23.5±8.8 months.In all,166 children received 1483 doses of vaccine with an overall adverse reaction incidence of 1.3‰.Conclusions Individualized vaccination recommendations for children surviving cancer are feasible and safe.

关 键 词：疫苗 预防接种 接种推荐 肿瘤存活儿童 

分 类 号：R186[医药卫生—流行病学] R725[医药卫生—公共卫生与预防医学]