剛剛遇到一個年長女性. 七天前接種13價肺炎鏈球菌疫苗, 昨天疫苗注射部位紅腫痛. 順便查詢了一下肺炎鏈球菌每年死亡人數及紅腫反應發生率
[113-08-07] 衛福部焦點新聞. 肺炎躍居十大死因第三位，父親節守護爸爸健康，呼籲爸爸們踴躍接種肺炎鏈球菌疫苗，提升免疫保護力
疾管署說明，依據疾管署監測資料顯示，國內今(2024)年截至8月5日累計199例侵襲性肺炎鏈球菌感染症確定病例，為2020年以來同期新高，其中23例死亡，病例中以65歲以上民眾占38%(75例)、男性占61%(122例)為多；另根據衛福部十大死因統計，去(2023)年肺炎死亡1.7萬人，已躍居十大死因第三位，且男性肺炎死亡率為女性1.5倍，顯示男性更須注意防範肺炎威脅。
關於13價肺鏈疫苗的遲發性腫脹發生率. 查到 2018 年一篇文章
是否發生延遲腫脹主要跟年齡有相關. 跟疫苗是否有cross-reactive material 197 (CRM197) 相關.
注射含AlPO4佐劑的PVC13 人數 5667
注射不含AlPO4佐劑的PVC13 人數 304
注射6-13天之間的腫脹發生率
Late onset of injection site reactions after vaccination with the 13-valent pneumococcal conjugate vaccine in adult study populations
Christine Juergens 1, James Trammel 2, Yasuko Shoji 3, Scott Patterson 4, Wendy Watson 4, Chris Webber 5, William C Gruber 5, Daniel A Scott 4, Beate Schmoele-Thoma 1
Affiliations ExpandPMID: 29543583
PMCID: PMC6149808
DOI: 10.1080/21645515.2018.1452576
Abstract
Injection site reactions (ISRs; redness, swelling and pain) commonly occur within 1-2 days after vaccination. After administration of toxoid vaccines including diphtheria toxoid, a later onset of ISRs has also been observed. As the serotype capsular polysaccharides in the 13-valent pneumococcal conjugate vaccine (PCV13) are conjugated to cross-reactive material 197 (CRM197), a nontoxic variant of diphtheria toxin, the onset of ISRs over 14 days was explored in 8 adult studies with 19 cohorts. Subjects received PCV13 with aluminum phosphate (AlPO4, n = 5667) or without AlPO4 (n = 304); 1097 subjects received 23-valent pneumococcal polysaccharide vaccine (PPSV23). Late ISRs with onset between days 6-14 were observed in 8/8 cohorts aged ≥65 years after PCV13 with AlPO4 (incidence across cohorts for redness, 2.3%-19.6%; swelling, 0.9%-10.8%; pain, 1.6%-10.0%) and in 1/1 cohort after PCV13 without AlPO4 (redness 10.5%; swelling 7.5%; pain 12.3%); and in 2/4 cohorts aged 50 to 64 years after PCV13 (redness 3.1%-4.8%; swelling 1.0%-3.2%; pain 3.7%-5%).
注射不含AlPO4佐劑的PVC13 人數 304
注射6-13天之間的腫脹發生率
65歲以上. PCV13 + AlPO4佐劑= 0.9%~10.8%
65歲以上. PCV13 不含AlPO4佐劑=7.5%
50-64 歲. PCV13= 1~3.2%
不含cross-reactive material 197 (CRM197)18-49歲有一篇研究. 沒發生案例
不含cross-reactive material 197 (CRM197)53歲以上有兩篇研究. 沒發生案例
不含cross-reactive material 197 (CRM197)60歲以上有三篇研究. 沒發生案例
Late onset of injection site reactions after vaccination with the 13-valent pneumococcal conjugate vaccine in adult study populations
Christine Juergens 1, James Trammel 2, Yasuko Shoji 3, Scott Patterson 4, Wendy Watson 4, Chris Webber 5, William C Gruber 5, Daniel A Scott 4, Beate Schmoele-Thoma 1
Affiliations ExpandPMID: 29543583
PMCID: PMC6149808
DOI: 10.1080/21645515.2018.1452576
Abstract
Injection site reactions (ISRs; redness, swelling and pain) commonly occur within 1-2 days after vaccination. After administration of toxoid vaccines including diphtheria toxoid, a later onset of ISRs has also been observed. As the serotype capsular polysaccharides in the 13-valent pneumococcal conjugate vaccine (PCV13) are conjugated to cross-reactive material 197 (CRM197), a nontoxic variant of diphtheria toxin, the onset of ISRs over 14 days was explored in 8 adult studies with 19 cohorts. Subjects received PCV13 with aluminum phosphate (AlPO4, n = 5667) or without AlPO4 (n = 304); 1097 subjects received 23-valent pneumococcal polysaccharide vaccine (PPSV23). Late ISRs with onset between days 6-14 were observed in 8/8 cohorts aged ≥65 years after PCV13 with AlPO4 (incidence across cohorts for redness, 2.3%-19.6%; swelling, 0.9%-10.8%; pain, 1.6%-10.0%) and in 1/1 cohort after PCV13 without AlPO4 (redness 10.5%; swelling 7.5%; pain 12.3%); and in 2/4 cohorts aged 50 to 64 years after PCV13 (redness 3.1%-4.8%; swelling 1.0%-3.2%; pain 3.7%-5%).
Late ISRs were not generally observed in 1/1 cohort aged 18 to 49 years after PCV13; in 2/2 cohorts aged ≥53 years after PCV13 revaccination; and in 3/3 cohorts aged ≥60 years who received PPSV23, which does not contain CRM197.
Post hoc analysis demonstrated numerically higher pneumococcal immune responses in subgroups with late ISRs versus those without. In conclusion, causality of late ISRs is likely multifactorial, with age and the PCV13 carrier protein CRM197 potentially associated. AlPO4, a vaccine adjuvant, did not appear causally related. Observations do not affect the favorable risk-benefit profile of PCV13.
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