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Influenza Vaccination Reduced the Incidence of Guillain-Barre Syndrome in the Elderly in Taiwan

施打流感疫苗能夠降低台灣老人格林-巴利式綜合症候群的發生率

摘要


Influenza is a serious threat to humans and has major health and economic impact globally; therefore, numerous countries have conducted a mass immunisation program against seasonal influenza. However, diseases such as Guillain- Barré syndrome (GBS) are regarded as potential adverse effects of influenza vaccination. GBS is a peculiar neurological illness, a postinfectious disease triggering immune dysregulation leading to neurological dysfunction. Could a temporal link between vaccine exposure and a subsequent adverse event indicate that the vaccine directly caused the event? Identifying such a link could cause public panic and result in increased morbidity and mortality owing to decreased vaccination. Analysing comprehensive electronic medical records of Taiwan National Health Insurance (NHIRD) claims and Taiwan Centres for Disease Control (Taiwan CDC) databases, Huang et al. determined the local background incidence of GBS after influenza vaccination. Although these unprecedented values provide evidence of vaccination safety and contribute to global health policies, whether influenza vaccination can protect against vaccination-related GBS was not addressed in Huang's report. To highlight this issue, we reanalysed the NHIRD and Taiwan CDC databases and discovered that H1N1 vaccination not only can protect from influenza and influenza-associated critical conditions; it can also decrease the incidence of influenza and vaccination-related GBS, especially in people older than 65 years. Hence we recommend that the vaccine should be administered to individuals older than 65 years.

並列摘要


流感是對人類有嚴重的威脅,對於全世界具有重大的健康和經濟影響,因此,許多國家對於季節性流感進行了大規模疫苗接種計畫。格林-巴利症候群(Guillain-Barré syndrome; GBS)是一種特殊的神經疾病,它的病因可能是因為像流感等疾病的感染後所引發的免疫異常連帶影響到神經功能;也可能是疫苗接種後所產生的許多不良反應之一。但把GBS與流感疫苗的關聯性的過度解讀與渲染,不只會引發大眾對疫苗的恐慌,還可能會引發疫苗接種的減少而導致增加新型流感的發病率和死亡率。儘管GBS確實是在疫苗接種後就接踵而來的產生,但這種短暫的關聯性,是否就能意味著疫苗就是直接導致GBS的主因呢?藉由分析台灣衛生福利部中央健康保險署(NHI)和台灣疾管局(CDC)資料庫中的資料,CDC黃醫師推估出流感疫苗接種後可能引發GBS的台灣本土背景發生率。此前所未有的數據不但證實了流感疫苗接種的安全性,也有助於全球衛生政策的推展。然而此報告並沒有提到流感疫苗接種是否真能有效減少流感疫苗有關的GBS。為了釐清此問題,我們再分析台灣衛生福利部中央健康保險署和台灣CDC資料庫,發現流感疫苗接種不僅可預防流感,減少流感重症的發生,也可對抗疫苗接種相關的GBS,特別是在大於65歲的老年人,因此我們呼籲民眾特別是老年人最好接種流感疫苗。

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