Transient Suppression of Atopy in Early Childhood Is Associated With High Vaccination Coverage

Christoph Grüber, MD*, Sabina Illi, MPH, Susanne Lau, MD, PhD*, Renate Nickel, MD*, Johannes Forster, MD, PhD, Wolfgang Kamin, MD||, Carl-Peter Bauer, MD, PhD¶, Volker Wahn, MD, PhD# and Ulrich Wahn, MD, PhD* MAS-90 Study Group

* Department of Pediatric Pneumology and Immunology, Charité-Humboldt University, Berlin, Germany

Department of Pulmonology and Allergology, Ludwig Maximilians University, Munich, Germany

St. Hedwig Hospital, Freiburg/Breisgau, Germany

|| Department of Pediatric Pneumology, Johannes Gutenberg University, Mainz, Germany

¶ University Children’s Hospital, Technical University, Munich, Germany

# Klinikum Uckermark, Schwedt/Oder, Germany

Objective. To analyze prevalences of allergic sensitization and atopic disease in relation to vaccination coverage.

Methods. A German atopy risk-enhanced birth cohort of 1314 neonates who were born in 1990 in 5 German cities was studied. A total of 943 children participated in the follow-up visit at 5 years of age. Atopic symptoms and diagnoses (derived from structured interviews), total serum immunoglobulin E, and specific immunoglobulin E against 9 common allergens (CAP Radio-Allergo-Sorbent Test Fluoro-Enzyme Immunoassay) were evaluated. Children were grouped into dose percentiles according to cumulative doses of any vaccine given up to 5 years of age (<10%, 0–11 doses; 10%–50%, 12–14 doses; 51%–90%, 15–20 doses; >90%, 21–27 doses).

Results. The cumulative vaccine dose was inversely related to atopic dermatitis prevalences at 6 months (13.8%, 5.2%, 5.1%, and 4.5%), 2 years (16.9%, 10.9%, 7.4%, and 3.7%), 3 years (27.6%, 16.4%, 13.5%, and 4.5%), and 5 years (28.3%, 16.0%, 9.3%, and 11.9%). Asthma followed a similar pattern at age 3 (22.4%, 8.6%, 6.7%, and 6.3%), age 4 (20.0%, 8.6%, 8.9%, and 8.1%), and age 5 (20.8%, 12.6%, 10.3%, and 5.5%). Allergic sensitization rates were inversely related to the cumulative vaccine dose at age 2 (37.5%, 29.1%, 23.8%, and 12.9%).

Conclusion. Children with a higher vaccination coverage seemed to be transiently better protected against development of atopy in the first years of life.

Key Words: child • preschool • vaccination • asthma • atopic dermatitis • immunoglobulin E

Abbreviations: IgE, immunoglobulin E • OR, odds ratio • CI, confidence interval

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