Patterns of childhood immunization and all-cause mortality

Details

• Alternative Title:
  Vaccine
• Personal Author:
  McCarthy, Natalie L. ; Sukumaran, Lakshmi ; Newcomer, Sophia ; Glanz, Jason ; Daley, Matthew F. ; McClure, David ; Klein, Nicola P. ; Irving, Stephanie ; Jackson, Michael L. ; Lewin, Bruno ; Weintraub, Eric
• Description:
  Background
  
  Evidence supports the safety of the recommended childhood immunization schedule as a whole. However, additional research is warranted as parents’ refusing or delaying vaccinations has increased in recent years. All-cause mortality has been identified as a priority outcome to study in the context of the recommended immunization schedule.
  
  Methods
  
  We included children born January 1, 2004 through December 31, 2009, enrolled in the Vaccine Safety Datalink (VSD) from birth through 18 months of age. We examined vaccination patterns during the first 18 months of life among 8 vaccines, and identified deaths occurring between 19 and 48 months of age. We excluded children with complex chronic conditions, contraindications to vaccination, and deaths due to injuries, congenital anomalies, or diseases with onset prior to 19 months of age. We calculated mortality rates among children with different patterns of immunization, and incidence rate ratios (IRR) using the Cox proportional hazards model for children vaccinated according to the schedule versus undervaccinated children, adjusting for outpatient healthcare utilization, influenza vaccination, sex, and VSD site.
  
  Results
  
  Among 312,388 children in the study, 199,661 (64%) were vaccinated according to the schedule, and 112,727 (36%) were delayed or not vaccinated for at least one vaccine dose. Of 18 deaths eligible for analysis, 11 occurred in children following the schedule (2.28 per 100,000 person-years), and seven occurred in undervaccinated children (2.57 per 100,000 person-years). Mortality rates among children following the schedule were not significantly different from those of undervaccinated children when excluding deaths with unknown causes (IRR = 1.29, 95% CI = 0.33–4.99), as well as when including deaths with unknown causes (IRR = 0.84, 95% CI = 0.32–2.99).
  
  Conclusion
  
  Although there were few deaths, our results do not indicate a difference in risk of all-cause mortality among fully vaccinated versus undervaccinated children. Our findings support the safety of the currently recommended immunization schedule with regard to all-cause mortality.
  
  
• Subjects:
  Child, Preschool Humans Immunization Immunization Schedule Infant Infant, Newborn Male Mortality Proportional Hazards Models Risk Factors Vaccines

  More +
• Keywords:
  Schedule Vaccine Safety
• Source:
  Vaccine. 35(48 Pt B):6643-6648
• Pubmed ID:
  29061349
• Pubmed Central ID:
  PMC6506838
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  35
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:d0d1508645f8402502cc971d331e5d6eb11fd04f256b2b36177ab7abb261b9f596b2827aee9b551eb25cfb796202ddf7b355f983a285562806de595ad9108a5d
• Download URL:
  https://stacks.cdc.gov/view/cdc/78387/cdc_78387_DS1.pdf
• File Type:
  [PDF - 189.87 KB ]