摘要：Objectives. We examined the effect of vaccination for diphtheria; polio; pertussis and tetanus; or measles, mumps, and rubella on the incidence of physician-diagnosed asthma and eczema. Methods. We used a previously established birth cohort in the West Midlands General Practice research database. Results. We found an association between vaccination and the development of allergic disease; however, this association was present only among children with the fewest physician visits and can be explained by this factor. Conclusions. Our data suggest that currently recommended routine vaccinations are not a risk factor for asthma or eczema. An unexplained increase in the prevalence of allergic disease has occurred in the developed world in the past few decades. 1 During the same period, there has been an increase in mass immunization, leading to the hypothesis that certain vaccines may increase the risk of allergic disease. There are 2 proposed mechanisms by which immunization may influence the development of allergic disease. The first is that vaccination could have a direct impact on the immune system, and there is evidence that pertussis vaccine enhances humans’ response to histamine 2 and leads to raised immunoglobulin E levels. 3 The second potential mechanism is that vaccination reduces the burden of childhood illness. Children with more older siblings are at a reduced risk of developing atopy and allergic disease. 4 It has been suggested that exposure to infection in childhood reduces a child’s risk of developing allergic disease; this is commonly known as the hygiene hypothesis. 5 In addition, there is also evidence that acceptance of vaccination is related to child birth order. 6– 11 Evidence to date has both supported and refuted the association between vaccination and allergic disease. 12– 23 It is clearly important to gain a detailed understanding of the relationship between vaccination and allergic disease, because a perception that vaccination is harmful may have an adverse impact on the effectiveness of immunization programs. 24
