Association Between Aluminum Exposure From Vaccines Before Age 24 Months and Persistent Asthma at Age 24 to 59 Months

Details

• Alternative Title:
  Acad Pediatr
• Personal Author:
  Daley, Matthew F. ; Reifler, Liza M. ; Glanz, Jason M. ; Hambidge, Simon J. ; Getahun, Darios ; Irving, Stephanie A. ; Nordin, James D. ; McClure, David L. ; Klein, Nicola P. ; Jackson, Michael L. ; Kamidani, Satoshi ; Duffy, Jonathan ; DeStefano, Frank
• Description:
  Objective:
  
  To assess the association between cumulative aluminum exposure from vaccines before age 24 months and persistent asthma at age 24 to 59 months.
  
  Methods:
  
  A retrospective cohort study was conducted in the Vaccine Safety Datalink (VSD). Vaccination histories were used to calculate cumulative vaccine-associated aluminum in milligrams (mg). The persistent asthma definition required one inpatient or 2 outpatient asthma encounters, and ≥2 long-term asthma control medication dispenses. Cox proportional hazard models were used to evaluate the association between aluminum exposure and asthma incidence, stratified by eczema presence/absence. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) per 1 mg increase in aluminum exposure were calculated, adjusted for birth month/year, sex, race/ethnicity, VSD site, prematurity, medical complexity, food allergy, severe bronchiolitis, and health care utilization.
  
  Results:
  
  The cohort comprised 326,991 children, among whom 14,337 (4.4%) had eczema. For children with and without eczema, the mean (standard deviation [SD]) vaccine-associated aluminum exposure was 4.07 mg (SD 0.60) and 3.98 mg (SD 0.72), respectively. Among children with and without eczema, 6.0% and 2.1%, respectively, developed persistent asthma. Among children with eczema, vaccine-associated aluminum was positively associated with persistent asthma (aHR 1.26 per 1 mg increase in aluminum, 95% CI 1.07, 1.49); a positive association was also detected among children without eczema (aHR 1.19, 95% CI 1.14, 1.25).
  
  Conclusion:
  
  In a large observational study, a positive association was found between vaccine-related aluminum exposure and persistent asthma. While recognizing the small effect sizes identified and the potential for residual confounding, additional investigation of this hypothesis appears warranted.
  
  
• Keywords:
  Aluminum Asthma Child Child, Preschool Eczema Humans Immunization Retrospective Studies Vaccines Vaccine Safety Vaccine Schedule

  More +
• Source:
  Acad Pediatr. 23(1):37-46
• Pubmed ID:
  36180331
• Pubmed Central ID:
  PMC10109516
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  23
• Issue:
  1
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:37c0d72dd4e37f845eba218f6d15ce7f3a40ef99e271d6cca55775ffe723736b
• Download URL:
  https://stacks.cdc.gov/view/cdc/127273/cdc_127273_DS1.pdf
• File Type:
  [PDF - 334.20 KB ]