[英语讨论]免疫接种:防止母亲对儿童乙肝传播的伦理问题

StephenW

Vaccine. 2011 Jun 29. [Epub ahead of print]
免疫接种:防止母亲对儿童乙肝传播的伦理问题
Ethical issues in preventing mother-to-child transmission of hepatitis B by
immunisation.

Isaacs D, Kilham HA, Alexander S, Wood N, Buckmaster A, Royle J.

Source

Clinical Ethics Advisory Group, Children's Hospital at Westmead, Westmead,
NSW, 2145, Australia; University of Sydney, NSW, 2006, Australia.

Abstract

Without intervention, a pregnant woman who is a chronic hepatitis B carrier
is at risk of transmitting hepatitis B and of her infant becoming a chronic
carrier and having a significantly increased lifetime risk of developing
liver cancer or cirrhosis. Hepatitis B vaccine and immunoglobulin reduce
the risk of the baby becoming a carrier, but with only a short window
period after birth to deliver this potentially life-saving intervention. We
reviewed the evidence on the magnitude of the risk. If the carrier mother
is e antigen positive (highly infective), the calculated risk to the infant
without intervention is 75.2%, reduced to 6.0% by giving vaccine and
immunoglobulin at birth. If the mother is surface antigen positive but e
antigen negative, the risk to the infant without intervention is 10.3%,
reduced to 1.0% by giving vaccine and immunoglobulin. If vaccine is
accepted but immunoglobulin refused, as for example by some Jehovah's
Witnesses, the risk to babies of e antigen positive mothers is reduced to
21.0% and to babies of e antigen negative mothers to 2.6%. These figures
can be used to inform parents and as a possible basis for child protection
proceedings if parents decline vaccine and/or immunoglobulin. We argue from
the perspective of the best interests of the child that the severity of the
condition justifies initiating child protection proceedings whenever a baby
is born to a hepatitis B carrier mother and, despite concerted attempts to
persuade them, the parents refuse vaccine and/or immunoglobulin.

Copyright © 2011. Published by Elsevier Ltd.

StephenW

谷歌翻译，不是100％准确，以供参考使用。

来源

临床伦理咨询小组，韦斯特米德的Westmead儿童医院，
NSW，2145，澳大利亚悉尼大学，新南威尔士州，2006年，澳大利亚。

摘要

不加干预，孕妇是一种慢性B型肝炎带
是一种慢性传染B型肝炎的风险和她的婴儿
承运人和发展有显着增加的寿命风险
肝癌或肝硬化。 B型肝炎疫苗和免疫球蛋白减少
宝宝成为承运人的风险，但只有很短的窗口
期间出生后提供这个潜在拯救生命的的干预措施。我们
审查证据，对风险的大小。如果承运人的母亲
e抗原阳性（高传染性），计算风险的婴儿
不进行干预，是75.2％，减少至6.0％给予疫苗和
出生免疫球蛋白在。如果母亲是表面抗原阳性但电子商务
抗原阴性，不进行干预，婴儿的风险是10.3％，
提供疫苗和免疫球蛋白降低到1.0％。如果疫苗
接受，但拒绝免疫球蛋白，例如，一些耶和华
证人，e抗原阳性母亲的婴儿的风险减少到
21.0％至2.6％的e抗原阴性母亲的婴儿。这些数字
用来告知家长，并为保护儿童的一个可能的基础
如果父母下降疫苗和/或免疫球蛋白的诉讼。我们认为，从
儿童的最佳利益的角度出发的严重性
每当一个婴儿条件证明发起保护儿童的法律程序
到B型肝炎带母亲所生，尽管采取协调一致的尝试
说服他们，家长拒绝疫苗和/或免疫球蛋白。

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