Jak się bada bezpieczeństwo szczepionek?

Zgodnie z wynikami badań naukowych bazujących na medycynie opartej na faktach (Evidence Base Medicine, EBM), publikowanych w recenzowanych czasopismach, nie ma związku między szczepieniami i autyzmem. Przytłaczające dowody wymieniono w reprezentatywnych recenzowanych artykułach, opublikowanych w prestiżowych czasopismach (z wysokim współczynnikiem IF).

Poniższa lista obejmuje recenzowane artykuły naukowe opublikowane w renomowanych czasopismach, które nie potwierdzają korelacji (związku przyczynowego) rozwoju zaburzeń ze spektrum autyzmu (ASD) oraz szczepień.

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91. Madsen KM, Lauritsen MB, Pedersen CB, Thorsen P, Plesner AM, Andersen PH, Mortensen PB. Thimerosal and the occurrence of autism: negative ecological evidence from Danish population-based data. Pediatrics. 2003 Sep;112(3 Pt 1):604-6. PubMed PMID: 12949291.
92. Madsen KM, Vestergaard M. MMR vaccination and autism : what is the evidence for a causal association? Drug Saf. 2004;27(12):831-40. Review. PubMed PMID: 15366972.
93. Maglione MA, Das L, Raaen L, Smith A, Chari R, Newberry S, Shanman R, Perry T, Goetz MB, Gidengil C. Safety of Vaccines Used for Routine Immunization of US Children: A Systematic Review. Pediatrics; 2014 July 1 (published online). doi: 10.1542/peds.2014-1079
94. Mäkelä A, Nuorti JP, Peltola H. Neurologic disorders after measles-mumps-rubella vaccination. Pediatrics. 2002 Nov;110(5):957-63. PubMed PMID: 12415036.
95. Marin M, Broder KR, Temte JL, Snider DE, Seward JF; Centers for Disease Control and Prevention (CDC). Use of combination measles, mumps, rubella, and varicella vaccine: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2010 May 7;59(RR-3):1-12. PubMed PMID: 20448530.
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Zespół Downa jest jednym z najczęstszych zespołów wad wrodzonych. Dochodzi do niego na skutek aberracji chromosomowej, czyli nieprawidłowego podziału materiału genetycznego w momencie łączenia się komórki jajowej i plemnika. Charakteryzuje się obecnością dodatkowego chromosomu 21 albo jego części, co prowadzi do wielu wad rozwojowych.

Dzieci z zespołem Downa powinny być szczepione zgodnie z kalendarzem szczepień. Zespół Downa jako taki nie stanowi przeciwwskazania do szczepienia. Jednak podobnie jak w przypadku dzieci bez obciążeń genetycznych musimy wziąć pod uwagę czynniki oceniane w czasie kwalifikacji pacjenta do szczepienia. Stąd też, np. wystąpienie objawów neurologicznych (np. padaczki) może być czasowym przeciwwskazaniem do szczepień (szczególnie w przypadku szczepionki ze składnikiem krztuścowym czy tez szczepionki przeciw odrze, śwince i różyczce). Z drugiej strony ponieważ dzieci z zespołem Downa mogą mieć dodatkowe obciążenia oraz predyspozycje do rozwoju wad serca czy ciężkich zapaleń płuc i wielu innych schorzeń bardzo jest rozszerzenie obowiązkowego kalendarza szczepień i  uwzględnienie szczepień przeciw pneumokokom, grypie, meningokokom, czy ospie wietrznej. W takim wypadku choroba przewlekła jest wskazaniem do rozszerzenia kalendarza sczepień i zastosowania dodatkowej profilaktyki.