DeStefano F, Gu D, Kramarz P, Truman BI, Iademarco MF, Mullooly JP, Jackson
LA, Davis RL, Black SB, Shinefield HR, Marcy SM, Ward JI, Chen RT; Vaccine
Safety Datalink Research Group.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
BACKGROUND: A few previous studies have suggested that childhood vaccines,
particularly whole cell pertussis vaccine, may increase the risk of asthma. We
evaluated the suggested association between childhood vaccinations and risk of
asthma. METHODS: Cohort study involving 167,240 children who were enrolled in 4
large health maintenance organizations during 1991 to 1997, with follow-up from
birth until at least 18 months to a maximum of 6 years of age. Vaccinations were
ascertained through computerized immunization tracking systems, and onset of
asthma was identified through computerized data on medical care encounters and
medication dispensings. RESULTS: In the study 18,407 children (11.0%) developed
asthma, with a median age at onset of 11 months. The relative risks (95%
confidence intervals) of asthma were: 0.92 (0.83 to 1.02) for diphtheria,
tetanus and whole cell pertussis vaccine; 1.09 (0.9 to 1.23) for oral polio
vaccine; 0.97 (0.91 to 1.04) for measles, mumps and rubella (MMR) vaccine; 1.18
(1.02 to 1.36) for Haemophilus influenzae type b (Hib); and 1.20 (1.13 to 1.27)
for hepatitis B vaccine. The Hib result was not consistent across health
maintenance organizations. In a subanalysis restricted to children who had at
least 2 medical care encounters during their first year, the relative risks
decreased to 1.07 (0.71 to 1.60) for Hib and 1.09 (0.88 to 1.34) for hepatitis B
vaccine. CONCLUSION: There is no association between diphtheria, tetanus and
whole cell pertussis vaccine, oral polio vaccine or measles, mumps and rubella
vaccine and the risk of asthma. The weak associations for Hib and hepatitis B
vaccines seem to be at least partially accounted for by health care utilization
or information bias.
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MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.