Joseph Y Abrams1, Eric S Weintraub2, James M Baggs2, Natalie L McCarthy2, Lawrence B Schonberger3, Grace M Lee4, Nicola P Klein5, Edward A Belongia6, Michael L Jackson7, Allison L Naleway8, James D Nordin9, Simon J Hambidge10, Ermias D Belay3. 1. Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States. Electronic address: jabrams@cdc.gov. 2. Immunization Safety Office, Division of Healthcare Quality and Promotion, Centers for Disease Control and Prevention, Atlanta, GA, United States. 3. Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, United States. 4. Harvard Pilgrim Health Care Institute, Boston, MA, United States. 5. Kaiser Permanente Vaccine Study Center, Oakland, CA, United States. 6. Marshfield Clinic Research Foundation, Marshfield, WI, United States. 7. Group Health Research Institute, Seattle, WA, United States. 8. Kaiser Permanente Northwest, Portland, OR, United States. 9. HealthPartners Research Foundation, Minneapolis, MN, United States. 10. Kaiser Permanente Colorado, Denver, CO, United States.
Abstract
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=0.38, 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.
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=0.38, 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.
Authors: M A Bordea; C Costache; A Grama; A I Florian; I Lupan; G Samasca; D Deleanu; P Makovicky; P Makovicky; K Rimarova Journal: Physiol Res Date: 2022-01-19 Impact factor: 1.881
Authors: Natália Gibim Mellone; Marcus Tolentino Silva; Mariana Del Grossi Paglia; Luciane Cruz Lopes; Sílvio Barberato-Filho; Fernando de Sá Del Fiol; Cristiane de Cássia Bergamaschi Journal: Front Pharmacol Date: 2019-09-24 Impact factor: 5.810
Authors: Anne E Wormsbecker; Caitlin Johnson; Laura Bourns; Tara Harris; Natasha S Crowcroft; Shelley L Deeks Journal: PLoS One Date: 2019-01-15 Impact factor: 3.240