Zifukwa 8 Zomwe Makolo Samatemera (ndi Zomwe Amayenera Kuchita)

Zamkati

• 1. Kuda nkhawa: "Katemera wambiri posachedwa agonjetsa chitetezo cha mwana wanga."
• 2. Chodetsa nkhawa: "Chitetezo cha mwana wanga sichikhala chokhwima, motero ndibwino kuchedwetsa katemera wina kapena kungopeza ofunika kwambiri."
• 3. Nkhawa: "Matemera ali ndi poizoni, monga mercury, aluminiyamu, formaldehyde, ndi antifreeze."
• 4. Chodetsa nkhawa: "Katemera sagwira ntchito kwenikweni-yang'anani katemera wa chimfine chaka chatha."
• 5. Zodandaula: "Sipangakhale 'makhothi a katemera' ngati katemera siowopsa."
• 6. Zodandaula: "Katemera amaoneka ngati njira yoti makampani azamankhwala azipanga ndalama zambiri."
• 7. Kuda nkhawa: "Zotsatira zoyipa za katemera wina zimawoneka zoyipa kuposa matenda enieni."
• 8. Zodandaula: "Kundikakamiza kuti ndipereke katemera ndi kuphwanya ufulu wanga."
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M'nyengo yozizira yatha, pamene matenda 147 a chikuku anafalikira m'maiko asanu ndi awiri, kuphatikiza Canada ndi Mexico, makolo sanachite mantha, mwina chifukwa choti mliriwu unayambira ku Disneyland, ku California. Koma zitha kukhala zoyipa kwambiri. Pakanakhala kuti mulibe katemera wa chikuku, tikadakhala ndi milandu pafupifupi 4 miliyoni ku US chaka chilichonse. Katemerayu asanafike mu 1963, pafupifupi aliyense anali ndi matendawa ali mwana, ndipo pafupifupi ana 440 amamwalira chaka chilichonse mzaka 10 zapitazo. Mwamwayi, lero pakati pa 80 ndi 90 peresenti ya ana amalandira katemera ambiri. Koma m'madera ena ku U.S., makolo ochulukirapo akusankha. Izi zikachitika, amakhala pachiwopsezo chofalikira mdera lawo. Chifukwa chofala kwambiri chomwe makolo amaponyera katemera? Kuda nkhawa ndi chitetezo, ngakhale pali umboni wochuluka wosonyeza kuti siowopsa. Umboni waposachedwa kwambiri: lipoti lokwanira la 2013 lochokera ku Institute of Medicine lomwe lapeza kuti dongosolo la katemera wa ana ku U.S. (Ndipo ife tifika kwa izo.)

Mwina chida chofunikira kwambiri m'mbiri yonse, katemera ndiwopambana. "Iwo ndi othandiza kwambiri, amachotsa matenda ngati chikuku. Koma ndiye timayiwala kuti matendawo ndi owopsa," anatero Kathryn Edwards, M.D., mkulu wa Vanderbilt University Vaccine Research Programme, ku Nashville. Mauthenga olakwika okhudza katemera amathandizanso kuti anthu azikhala ndi nkhawa, ndipo kusankha chowonadi kuchokera m'nthano sikophweka nthawi zonse.Malingaliro olakwika akuti katemera wa chikuku-mumps-rubella (MMR) angayambitse autism akhala m'maganizo a makolo ena kwazaka zopitilira khumi ngakhale kafukufuku wopitilira khumi ndi awiri wosonyeza kulumikizana pakati pa awiriwa.

Katemera ali ndi zoopsa, koma ubongo wathu umavutika kuti uwonetsere zoopsa, akutero Neal Halsey, MD, dokotala wa ana komanso mkulu wa Institute for Vaccine Safety pa yunivesite ya Johns Hopkins, ku Baltimore. Anthu amaopa kuuluka kwambiri kuposa kuyendetsa chifukwa kuyendetsa ndikofala komanso kwodziwika, koma kuyendetsa ndi kowopsa kwambiri. Kutemera ana kuti atetezedwe ku matenda owopsa kungayambitse zotsatira zochepa, zazing'ono, monga kufiira ndi kutupa pamalo opangira jakisoni, kutentha thupi, ndi zidzolo. Koma zoopsa zazikuluzikulu, monga zovuta zina, zimakhala zochepa kwambiri kuposa momwe katemera amatetezera. Bungwe la Centers for Disease Control and Prevention likuyerekeza kuti chiopsezo cha kusagwirizana ndi katemera aliyense ndi chimodzi mwa 1 miliyoni mlingo.

Ngakhale atakhala pachiwopsezo chochepa, makolo ena amathabe kukhala ndi nkhawa, ndipo ndizomveka. Izi ndi zomwe simumakonda kumva kuchokera kwa akatswiri a katemera: Nthawi zambiri pamakhala chowonadi pazovuta za makolo, ngakhale samvetsetsa zina mwazinthu, Dr. Halsey akutero. Izi zimapangitsa kuti zikhale zokhumudwitsa kwambiri ngati dokotala akuchotsa mantha anu kapena akukakamira katemera popanda kuyankha mafunso anu onse. Nthawi zina, madokotala akukana kuchiza ana omwe makolo awo salandira katemera, ngakhale American Academy of Pediatrics (AAP) savomereza zimenezo. Chifukwa chake tikukupatsirani nkhawa zomwe zimafala kwambiri.

1. Kuda nkhawa: "Katemera wambiri posachedwa agonjetsa chitetezo cha mwana wanga."

Chowonadi: Makolo obadwa m'zaka za m'ma 1970 ndi m'ma 80 adalandira katemera wa matenda asanu ndi atatu. Katemera wazaka ziwiri lero, kumbali ina, akhoza kugonjetsa matenda 14. Chifukwa chake pomwe ana tsopano amapeza kuwombera kwambiri - makamaka popeza katemera aliyense amafunika kuchuluka kwake - amatetezedwanso kumatenda owirikiza kawiri.

Koma si kuchuluka kwa kuwombera komwe kumafunika; ndi zomwe zili mwa iwo. Ma antigen ndi omwe ali ndi kachilombo koyambitsa matenda kamene kamayambitsa chitetezo cha mthupi kuti chimange ma antibodies ndikulimbana ndi matenda amtsogolo. Ma antigen onse omwe ana amalandila mu katemera masiku ano ndi kachigawo kakang'ono kamene ana ankalandira, kuphatikizapo katemera wophatikizana.

"Ndine katswiri wa matenda opatsirana, koma sindimawona matenda mwa ana atatha kulandira katemera wanthawi zonse ali ndi miyezi 2, 4, ndi 6, zomwe zingachitike ngati chitetezo chawo cha mthupi chitadzaza," adatero. atero a Mark H. Sawyer, MD, pulofesa wazachipatala ku University of California San Diego School of Medicine ndi Rady Children's Hospital.

2. Chodetsa nkhawa: "Chitetezo cha mwana wanga sichikhala chokhwima, motero ndibwino kuchedwetsa katemera wina kapena kungopeza ofunika kwambiri."

Chowonadi: Kumeneku ndiko kusamvana kwakukulu pakati pa makolo lerolino, akutero Dr. Halsey, ndipo kumabweretsa nthaŵi yaitali ya kutengeka ndi matenda monga chikuku. Pankhani ya MMR, kuchedwetsa katemera kwa miyezi itatu ngakhale pang'ono kumawonjezera ngozi yakugwidwa ndi kachilombo.

Palibe umboni wosonyeza kuti kulekanitsa katemera ndikotetezeka. Zomwe zimadziwika ndikuti dongosolo lomwe lakonzedwa la katemera lakonzedwa kuti liziteteza kwambiri. M'malo mwake, akatswiri ambiri a matenda opatsirana komanso akatswiri a miliri ochokera ku CDC, mayunivesite, ndi zipatala ku US akuwunika mosamalitsa kafukufuku wazaka zambiri asanapereke malingaliro awo.

3. Nkhawa: "Matemera ali ndi poizoni, monga mercury, aluminiyamu, formaldehyde, ndi antifreeze."

Chowonadi: Katemera amakhala ndimadzi okhala ndi ma antigen, koma amafunikira zowonjezera zowonjezera kuti athetse vuto kapena kuwonjezera mphamvu ya katemerayo. Makolo amadandaula za mercury chifukwa katemera wina anali ndi mankhwala osungunula, omwe amayamba kukhala ethylmercury. Ochita kafukufuku tsopano akudziwa kuti ethylmercury siyimadziunjikira mthupi mosiyana ndi methylmercury, neurotoxin yomwe imapezeka mu nsomba zina. Koma thimerosal idachotsedwa ku katemera wa makanda kuyambira 2001 "ngati chitetezo," akutero Dr. Halsey. (Katemera wa chimfine cha Multidose amakhalabe ndi thimerosal yothandiza, koma mlingo umodzi wopanda thimerosal ulipo.)

Katemera ali ndi mchere wa aluminium; Izi zimagwiritsidwa ntchito kuti chitetezo cha mthupi chitetezeke, kulimbikitsa kupanga ma antibodies ambiri ndikupangitsa kuti katemera akhale wogwira mtima. Ngakhale zotayidwa zimatha kuyambitsa kufiira kapena kutupa pamalo obayira jekeseni, kachilombo kakang'ono ka aluminiyamu katemera-kocheperako kuposa komwe ana amadutsa mkaka wa m'mawere, kapangidwe kake, kapena magwero ena-sikukhala ndi zotsatira zazitali ndipo kwakhala kukugwiritsidwa ntchito mu katemera wina kuyambira cha m'ma 1930. "Zili m'nthaka yathu, m'madzi athu, mumlengalenga. Muyenera kuchoka pa dziko lapansi kuti mupewe kuwonekera, "akutero dokotala wa ana ndi Makolo mlangizi Ari Brown, MD, waku Austin, Texas.

Tsatirani kuchuluka kwa formaldehyde, yomwe imagwiritsidwa ntchito poletsa kuipitsidwa komwe kungakhalepo, itha kukhalanso mu katemera wina, koma yocheperapo mazana kuposa kuchuluka kwa anthu a formaldehyde omwe amachokera kuzinthu zina, monga zipatso ndi zotchingira. Thupi lathu mwachilengedwe limapangitsanso formaldehyde kuposa zomwe zili ndi katemera, akutero Dr. Halsey.

Zosakaniza zina, komabe, zimabweretsa zoopsa zina. Maantibayotiki, monga neomycin, omwe amagwiritsidwa ntchito poletsa kukula kwa mabakiteriya m'makatemera ena, ndipo gelatin, yomwe imagwiritsidwa ntchito pafupipafupi kuteteza zigawo za katemera kuti zisakhale zonyozeka pakapita nthawi, zimatha kuyambitsa zovuta za anaphylactic (pafupifupi kamodzi kapena kawiri pa Mlingo wa 1 miliyoni). Katemera wina akhoza kukhala ndi kuchuluka kwa mapuloteni a dzira, koma kafukufuku waposachedwa awonetsa kuti ana omwe ali ndi chifuwa cha dzira nthawi zambiri amatha kuwalandirabe.

Ponena za antifreeze, sikuli mu katemera. Makolo akhoza kusokoneza mayina ake a mankhwala-onse a ethylene glycol ndi propylene glycol-ndi zinthu zomwe zimagwiritsidwa ntchito popanga katemera (monga polyethylene glycol tert-octylphenyl ether, yomwe siili yovulaza).

4. Chodetsa nkhawa: "Katemera sagwira ntchito kwenikweni-yang'anani katemera wa chimfine chaka chatha."

Chowonadi: Ambiri ndi 85 mpaka 95 peresenti ogwira ntchito. Katemera wa chimfine ndi wovuta kwambiri, komabe. Chaka chilichonse, akatswiri a matenda opatsirana padziko lonse lapansi amakumana kuti anene za mitundu yomwe ingathe kufalikira munyengo yotsatira ya chimfine. Kuchita bwino kwa katemerayu kumadalira mitundu yomwe amasankha-ndipo nthawi zina amalakwitsa. Katemera wa nyengo yathayi anali 23% yokha yothandiza popewera chimfine; kafukufuku wasonyeza kuti katemera akhoza kuchepetsa chiopsezo ndi pafupifupi 50 mpaka 60 peresenti pamene mtundu woyenera wasankhidwa.

Chifukwa chake, eya-katemera wa chimfine m'nyengo yozizira yapita anali wowoneka bwino, koma ngakhale 23% yocheperako amatanthauza kuti anthu masauzande ambiri adapulumuka. Chofunika kwambiri ndikuti katemera amatanthauza imfa zochepa, kulandilidwa kuchipatala, ndi olumala kuposa nthawi ina iliyonse m'mbiri.

5. Zodandaula: "Sipangakhale 'makhothi a katemera' ngati katemera siowopsa."

Chowonadi: Ngakhale kuti katemera ali wotetezeka, nthawi zambiri zotsatira zosayembekezereka zimachitika kawirikawiri, akutero Dr. Halsey. "Ndipo anthu sayenera kukhala ndi mavuto azachuma okhudzana ndi izi." Dipatimenti ya National Vaccine Injury Compensation Program (NVICP) imapereka ndalama kwa makolo kuti athe kulipirira ndalama zamankhwala ndi zina zomwe zimakhudzana ndi kuvulala panthawi yomwe mwana wawo angakumane ndi katemera woopsa. (Amalipiranso akuluakulu ovulala ndi katemera.)

Mungadabwe, bwanji osangosumira makampani opanga mankhwala? Izi ndizomwe zidachitika m'ma 1980, pomwe makampani khumi ndi awiri omwe amapanga katemera adakumana ndi milandu. Ambiri mwa milanduyo sanachite bwino, komabe; kupambana kunkafuna makolo kusonyeza kuti katemera anayambitsa vuto chifukwa anali ndi vuto. Koma katemerayo sanali wolakwika; iwo anali ndi chiopsezo chodziwika. Komabe, milandu inafika poipa. Makampani angapo adangosiya kupanga katemera, zomwe zidabweretsa kusowa.

"Ana amasiyidwa opanda katemera, motero Congress idalowererapo," atero a Dorit Reiss, pulofesa wodziwa bwino za katemera ku University of California Hastings College of Law. Choyamba idapereka chitetezo kwa opanga kuti asaimbidwe mlandu kukhothi pazovulala za katemera pokhapokha ngati wofunsayo adutsa NVICP koyamba, zomwe zimawalola kupitiliza kupanga katemera. Bungwe la Congress linapangitsanso kuti makolo azilandira malipiro mosavuta.

Makhothi a katemera amagwira ntchito "yopanda zolakwika." Makolo sayenera kutsimikizira kulakwa kwa wopanga ndipo sakuyenera kutsimikizira mopanda chikayikiro chilichonse kuti katemera wayambitsa vuto la thanzi. M'malo mwake, mikhalidwe ina imalipidwa ngakhale kuti sayansi sinawonetse kuti katemera ndiomwe adawayambitsa. Kuyambira 2006 mpaka 2014, madandaulo 1,876 adalipira. Izi zikutanthauza kuti munthu mmodzi amalipidwa pa mlingo uliwonse wa katemera wa 1 miliyoni womwe wagawidwa, malinga ndi Health Resources and Services Administration.

6. Zodandaula: "Katemera amaoneka ngati njira yoti makampani azamankhwala azipanga ndalama zambiri."

Chowonadi: Makampani opanga mankhwala amapeza phindu kuchokera ku katemera, koma si mankhwala osokoneza bongo. Ndi zomvekanso kwa makampani opanga mankhwala kupanga ndalama kuchokera kuzinthu zawo, monga momwe opanga mipando yagalimoto amapezera phindu kuchokera kuzinthu zawo. Mosiyana ndi zomwe anthu ambiri amakhulupirira, makampaniwa salandira ndalama kuchokera ku boma. Pafupifupi ndalama zonse zomwe zimayikidwa pakufufuza katemera ndi National Institutes of Health zimapita kumayunivesite.

Madokotala sakupindulanso, mwina. “Zochita zambiri sizipanga n’komwe ndalama kuchokera ku katemera ndipo kaŵirikaŵiri amataya kapena kuwaswa,” akutero Nathan Boonstra, M.D., dokotala wa ana pa Blank Children’s Hospital, ku Des Moines. "M'malo mwake, ena zimawawona kukhala okwera mtengo kwambiri kugula, kusunga, ndi kupereka katemera, ndipo amayenera kutumiza" odwala ku dipatimenti yazaumoyo. "

7. Kuda nkhawa: "Zotsatira zoyipa za katemera wina zimawoneka zoyipa kuposa matenda enieni."

Chowonadi: Zimatenga zaka khumi mpaka 15 ndi kafukufuku wambiri wa katemera watsopano kuti adutse magawo anayi onse oyesa chitetezo ndi mphamvu asanavomerezedwe. Katemera watsopano aliyense amayesedwa kwa ana amayesedwa koyamba mwa akulu, kenako kwa ana, ndipo mitundu yonse yatsopano ndi ma formulations ziyenera kudutsanso chimodzimodzi. A FDA ndiye amawunika zambiri kuti awonetsetse kuti katemera amachita zomwe wopanga akuti amachita - komanso mosatekeseka. Kuchokera kumeneko, CDC, AAP, ndi American Academy of Family Physicians amasankha kuvomereza. Palibe bungwe kapena kampani yomwe ingagwiritse ntchito ndalama mu katemera yemwe amachititsa mavuto azaumoyo kuposa momwe amalepheretsa, adatero Dr. Halsey: "Matendawa amayambitsidwa ndi zovuta zazikulu zomwe zingayambitse kuchipatala kapena ngakhale kufa."

Ngakhale nthomba, yomwe makolo ambiri anali nayo ali ana, idapha ana pafupifupi 100 chaka chisanayambike katemera wa varicella. Ndipo chinali choyambitsa chachikulu cha necrotizing fasciitis, kapena matenda omwe amabwera chifukwa cha bakiteriya. Dr. Halsey anamva makolo akunena kuti kudya bwino kumathandiza ana awo kulimbana ndi matendaŵa, koma nthawi zambiri sizikhala choncho. Ana athanzi ali pachiwopsezo chazovuta zakufa ndi matendawa. Mwachitsanzo, 80 peresenti ya anthu omwe amamwalira ndi nthomba adachitika mwa ana athanzi, adatero.

Ndizowona kuti zovuta zoyipa komanso zochepa - monga kukomoka kwa febrile ndi kutentha thupi kwambiri - sizimveka, koma zovuta zoyipa ndizosowa kwambiri. Mwachitsanzo, zotsatira zoyipa kwambiri za katemera wa rotavirus ndikumangirira, kutsekeka kwa matumbo komwe kungafune kuchitidwa opaleshoni ndipo kumachitika kamodzi mwa makanda 20,000 mpaka 100,000 omwe amatemeredwa.

8. Zodandaula: "Kundikakamiza kuti ndipereke katemera ndi kuphwanya ufulu wanga."

Chowonadi: Malamulo a katemera a boma lililonse ndi osiyana; Zofunikira pa katemera zimayamba ikafika nthawi yoti mukakhale nawo kusamalira ana kusukulu, kapena kusukulu yaboma. Ndipo pachifukwa chabwino: Amateteza kuchuluka kwa ana omwe atha kukhala ndi chitetezo cha mthupi kapena omwe katemera sagwira ntchito. Dziko lililonse limalola kuti ana asamalandire chithandizo ngati ali ndi chifukwa chachipatala cholepheretsa katemera, monga kukhala ndi khansa ya m'magazi kapena matenda osowa chitetezo cha mthupi. Kuphatikiza apo, mayiko onse amalola kukhululukidwa pazipembedzo komanso / kapena zikhulupiriro zawo, ndizosiyanasiyana, kupatula ku California (kuyambira Julayi 2016), Mississippi, ndi West Virginia. Pakali pano, chiwopsezo cha anthu okhululukidwa—ndi chiwopsezo cha matenda—ndichokwera kwambiri m’maiko amenewo kumene kumakhala kosavuta kuti ana aloledwe.

"Dera lirilonse liri ndi ufulu wokhala ndi chitetezo chokwanira kwa ana omwe sangathe kulandira katemera," akutero Dr. Halsey. Kufunika kwa chitetezo cham'derali, chomwe chimatchedwanso kuti ziweto, chimawonekera bwino kwambiri nthawi ya Disneyland. Chifukwa chikuku chimafala kwambiri, chimafalikira mwachangu kudera lomwe limalandira katemera wocheperako. Disneyland ili pakatikati pa Southern California, yomwe ili ndi katemera wotsika kwambiri m'boma, ndipo milandu yambiri inali pakati pa anthu aku California m'madera amenewo.

Dr. Halsey anafotokoza mwachidule kuti: “Chinthu chochititsa chidwi kwambiri n’chakuti katemera ndi wopindulitsa ndipo amasunga ana athanzi. Ndipo n’zimene tonsefe timafuna—makolo, opereka chithandizo chamankhwala, ndi anthu amene amapanga katemerawo.”

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