新生儿乙型肝炎疫苗接种:重新评估时间和佐剂以提高安全性和有效性

Aleksandar Cirovic, A. Ćirović, A. Ivanovski, P. Ivanovski
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摘要

我们的目标是使疫苗接种率达到 100%,且无疫苗毒性反应。我们对铝神经毒性和新生儿早期乙肝疫苗接种进行了全面的文献综述。我们分析了早期新生儿乙肝疫苗接种的适应症以及铝诱导神经毒性的实验和临床数据。在高风险流行地区进行早期乙肝疫苗接种是合理的。在这些国家,包括孕妇在内的大量乙型肝炎阳性患者会在怀孕期间导致大量的病毒母婴垂直传播。在这些国家,围产期感染乙肝病毒的风险也很高。低风险国家也会对新生儿进行早期乙肝疫苗接种,这些国家的乙肝阳性孕妇人数极少,因此需要预防乙肝感染的新生儿人数也极少。有必要立即停止所有含铝佐剂的儿童疫苗接种,直到他们开始走路,直到铝被钙、锌或微晶酪氨酸或尿酸单钠等非金属佐剂取代。同时,应持续努力研制所谓的白喉、百日咳、麻疹、流行性腮腺炎和风疹粘膜疫苗。同时,所有乙型肝炎阳性母亲所生的孩子,无论其出生地在哪里,都必须接种乙型肝炎疫苗,因为疫苗带来的益处远远大于铝佐剂可能造成的危害。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Neonatal hepatitis B vaccination: Reevaluating timing and adjuvants for enhanced safety and effectiveness
Our aim is an achievement of a 100 percent vaccination rate without toxic vaccine effects. We did a comprehensive literature review on aluminum neurotoxicity and early neonatal hepatitis B vaccination. We analyzed indications for introduction of early neonatal hepatitis B vaccination and the data on experimental and clinical aluminum‐induced neurotoxicity. It is justified very early hepatitis B vaccination to be carried out in high‐risk endemic areas. In those countries there is a large number of hepatitis B positive individuals, including pregnant women, which leads to a great number of vertical, mother‐to‐child, transmissions of the virus during pregnancy. There is also a serious risk of perinatal Hepatitis B virus infections in such countries. Early neonatal hepatitis B vaccination is also carried out in low‐risk countries, where the number of hepatitis B positive pregnant women is extremely small, making the number of newborns who require the prevention of hepatitis B infection extremely small as well. It is necessary for all vaccines which contain aluminum as an adjuvant to be immediately suspended as children vaccination until they start walking and until aluminum is replaced with calcium, zinc or a nonmetallic adjuvant such as microcrystalline tyrosine or monosodium urate. Meanwhile sustained efforts should be made to create the so‐called mucosal vaccines against diphtheria, pertussis, measles, mumps and rubella. At the same time, all the children born to hepatitis B positive mothers, regardless of their place of birth must be vaccinated against hepatitis B as the benefits from vaccines by far outweigh potential harm caused by adjuvant aluminum.
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