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zoom RSS 予防接種により死亡率が最低記録を更新/米国

<<   作成日時 : 2007/11/14 21:46   >>

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 小児の予防接種により予防可能な13の病気の死亡率が米国で1900年以来の最低記録を更新したと昨日発表された。
 このうち9の病気ではワクチン導入以来死亡率は90%減少し、天然痘、ジフテリア、ポリオは100%減少した。肝炎AB、肺炎球菌、水痘の4つについては90%未満だが、これらのワクチンはまだ導入からまだ時間があまりたっていない。
 かつてはよく見られた病気の後遺症を持つ子どもが減ったことで、ワクチンを受けない人が増えている。90年代までは貧しい子どもの予防接種は不完全だったが、94年にクリントン政権のワクチンプログラムによって無料でワクチン接種できるようになった。現在では、中流以上の人たちが副作用を気にして接種が不完全になっている。
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Sharp Drop Seen in Deaths From Ills Fought by Vaccine
http://www.nytimes.com/2007/11/14/health/14vaccine.html?_r=1&ref=health&oref=slogin
By DONALD G. McNEIL Jr.
Published: November 14, 2007
Death rates for 13 diseases that can be prevented by childhood vaccinations are at all-time lows in the United States, according to a study released yesterday.
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The study, by the Centers for Disease Control and Prevention in Atlanta, and published in The Journal of the American Medical Association, is the first time that the agency has searched historical records going back to 1900 to compile estimates of cases, hospitalizations and deaths for all the diseases children are routinely vaccinated against.

In nine of the diseases, rates of death or hospitalization declined more than 90 percent since vaccines against them were approved, and in the cases of smallpox, diphtheria and polio, by 100 percent.

In only four diseases ― hepatitis A and B, invasive pneumococcal diseases and varicella (the cause of chickenpox and shingles) ― did deaths and hospitalizations fall less than 90 percent. Those vaccines are all relatively new ― the one for chickenpox, for example, was adopted nationally only in 1995. Also, some diseases like hepatitis typically strike adults, who are less likely to be immunized.

The results “are a testament to the fact that vaccines can drive diseases down to near nil,” said Dr. Gregory A. Poland, chief of the vaccine research group at the Mayo Clinic.

And Dr. Robert W. Sears, an Orange County, Calif., pediatrician who writes popular medicine books for parents, including a new one on vaccines, said the study showed “one of the very positive aspects of vaccination.”

Public health officials are involved in a continuing struggle with antivaccine activists who contend that children’s shots trigger autism, seizures or other serious side effects, and that private pediatricians often cannot make time to answer all the questions worried parents have, Dr. Sears said.

A spokesman for the disease control agency, Curtis Allen, said the study was not done to counter groups that oppose vaccines, “but it does show conclusively the value of vaccines.”

It was in 1796 when Dr. Edward Jenner first vaccinated a boy against smallpox by pricking his arms with pus taken from the sores of a milkmaid with cowpox, a closely related but mild disease. Vaccines against whooping cough were introduced in 1914, against diphtheria in 1928, against tetanus in 1933, and so on, up to the latest introduction, seven years ago, of the pneumococcal vaccine.

The centers’ study estimates the peak years for deaths from each disease: more than 3,000 deaths from polio in 1952, for example, and more than 7,500 from whooping cough in 1934.

But as fewer parents see children killed, scarred or brain-damaged by diseases that were once common, “there’s been a shift in who’s not getting vaccinated,” said Dr. Paul A. Offit, chief of diseases at Children’s Hospital in Philadelphia and a vaccine expert.

Until the 1990s, Dr. Offit said, incomplete vaccination was most common among poor children with no health insurance. But the Vaccines for Children Program, created in 1994 by the Clinton administration, helped end that. It provides vaccines free to any eligible child, which includes 45 percent of American children, Mr. Allen said.

Now, Dr. Offit said, it is more common for children from wealthy or middle-class families to lack some or all shots, presumably because their parents have read about side effects or visited one of the many antivaccine Web sites.

Most children are immunized as part of routine infant care or before they enter day care or school, but the number of states that allow religious or “philosophical” exemptions has increased.

Public health officials worry that those children are vulnerable to diseases that still kill children in poor countries and occasionally arrive from abroad.

The study showed total or near-total declines in cases of diphtheria, measles, polio, rubella, smallpox and invasive Hib disease, a type of pneumonia for which children are now normally vaccinated at as early as 2 months.

In the 1930s in the United States, there were about 30,000 cases of diphtheria annually, in which a grayish membrane clogs the airways, killing about 10 percent of those infected. The disease virtually never appears in the West now, but in the 1980s, when vaccination stopped in the former Soviet Union in the chaos of its breakup, there were 200,000 cases and 5,000 deaths, by Red Cross estimates.

In the United States, rumors of a link to autism and inflammatory bowel disease are most commonly attached to the measles vaccine, making it one that some parents avoid.

Refusal is much more common in Britain, and in August the national Health Protection Agency warned that Britain was having its worst measles outbreak in 20 years, with 480 confirmed cases and one death.

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