Childhood vaccines and Kawasaki disease, Vaccine Safety Datalink, 1996-2006

被引：37

作者：

Abrams, Joseph Y. ^{[1
]}

Weintraub, Eric S. ^{[2
]}

Baggs, James M. ^{[2
]}

McCarthy, Natalie L. ^{[2
]}

Schonberger, Lawrence B. ^{[1
]}

Lee, Grace M. ^{[3
]}

Klein, Nicola P. ^{[4
]}

Belongia, Edward A. ^{[5
]}

Jackson, Michael L. ^{[6
]}

Naleway, Allison L. ^{[7
]}

Nordin, James D. ^{[8
]}

Hambidge, Simon J. ^{[9
]}

Belay, Ermias D. ^{[1
]}

机构：

[1] Ctr Dis Control & Prevent, Div High Consequence Pathogens & Pathol, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, Div Healthcare Qual & Promot, Immunizat Safety Off, Atlanta, GA USA

[3] Harvard Pilgrim Hlth Care Inst, Boston, MA USA

[4] Kaiser Permanente Vaccine Study Ctr, Oakland, CA USA

[5] Marshfield Clin Res Fdn, Marshfield, WI USA

[6] Grp Hlth Res Inst, Seattle, WA USA

[7] Kaiser Permanente Northwest, Portland, OR USA

[8] HealthPartners Res Fdn, Minneapolis, MN USA

[9] Kaiser Permanente Colorado, Denver, CO USA

来源：

VACCINE | 2015年 / 33卷 / 02期

关键词：

Kawasaki disease; Vaccine Safety Datalink; Adverse events; Vasculitis; INNATE IMMUNITY; IMMUNIZATION; CHILDREN;

D O I：

10.1016/j.vaccine.2014.10.044

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: Kawasaki disease is a childhood vascular disorder of unknown etiology. Concerns have been raised about vaccinations being a potential risk factor for Kawasaki disease. Methods: Data from the Vaccine Safety Datalink were collected on children aged 0-6 years at seven managed care organizations across the United States. Defining exposure as one of several time periods up to 42 days after vaccination, we conducted Poisson regressions controlling for age, sex, season, and managed care organization to determine if rates of physician-diagnosed and verified Kawasaki disease were elevated following vaccination compared to rates during all unexposed periods. We also performed case-crossover analyses to control for unmeasured confounding. Results: A total of 1,721,186 children aged 0-6 years from seven managed care organizations were followed for a combined 4,417,766 person-years. The rate of verified Kawasaki disease was significantly lower during the 1-42 days after vaccination (rate ratio = 0.50, 95% CL = 0.27-0.92) and 8-42 days after vaccination (rate ratio = 0.45, 95% CL = 0.22-0.90) compared to rates during unexposed periods. Breaking down the analysis by vaccination category did not identify a subset of vaccines which was solely responsible for this association. The case-crossover analyses revealed that children with Kawasaki disease had lower rates of vaccination in the 42 days prior to symptom onset for both physician-diagnosed Kawasaki disease (rate ratio = 0.79, 95% CL = 0.64-0.97) and verified Kawasaki disease (rate ratio = 038, 95% CL = 0.20-0.75). Conclusions: Childhood vaccinations' studied did not increase the risk of Kawasaki disease; conversely, vaccination was associated with a transient decrease in Kawasaki disease incidence. Verifying and understanding this potential protective effect could yield clues to the underlying etiology of Kawasaki disease. (C) 2014 Published by Elsevier Ltd.

引用

页码：382 / 387

页数：6

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