Natalie L McCarthy1, Julianne Gee2, Lakshmi Sukumaran3, Eric Weintraub2, Jonathan Duffy2, Elyse O Kharbanda4, Roger Baxter5, Stephanie Irving6, Jennifer King7, Matthew F Daley8, Rulin Hechter9, Michael M McNeil2. 1. Centers for Disease Control and Prevention, Atlanta, Georgia; nmccarthy@cdc.gov. 2. Centers for Disease Control and Prevention, Atlanta, Georgia; 3. Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia; 4. HealthPartners Institute for Education and Research, Minneapolis, Minnesota; 5. Kaiser Permanente of Northern California, Oakland, California; 6. Kaiser Permanente Northwest, Portland, Oregon; 7. Marshfield Clinic Research Foundation, Marshfield, Wisconsin; 8. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado; and. 9. Kaiser Permanente Southern California, Pasadena, California.
Abstract
OBJECTIVE: This study evaluates the potential association of vaccination and death in the Vaccine Safety Datalink (VSD). METHODS: The study cohort included individuals ages 9 to 26 years with deaths between January 1, 2005, and December 31, 2011. We implemented a case-centered method to estimate a relative risk (RR) for death in days 0 to 30 after vaccination.Deaths due to external causes (accidents, homicides, and suicides) were excluded from the primary analysis. In a secondary analysis, we included all deaths regardless of cause. A team of physicians reviewed available medical records and coroner's reports to confirm cause of death and assess the causal relationship between death and vaccination. RESULTS: Of the 1100 deaths identified during the study period, 76 (7%) occurred 0 to 30 days after vaccination. The relative risks for deaths after any vaccination and influenza vaccination were significantly lower for deaths due to nonexternal causes (RR 0.57, 95% confidence interval [CI] 0.38-0.83, and RR 0.44, 95% CI 0.24-0.80, respectively) and deaths due to all causes (RR 0.72, 95% CI 0.56-0.91, and RR 0.44, 95% CI 0.28-0.65). No other individual vaccines were significantly associated with death. Among deaths reviewed, 1 cause of death was unknown, 25 deaths were due to nonexternal causes, and 34 deaths were due to external causes. The causality assessment found no evidence of a causal association between vaccination and death. CONCLUSIONS: Risk of death was not increased during the 30 days after vaccination, and no deaths were found to be causally associated with vaccination.
OBJECTIVE: This study evaluates the potential association of vaccination and death in the Vaccine Safety Datalink (VSD). METHODS: The study cohort included individuals ages 9 to 26 years with deaths between January 1, 2005, and December 31, 2011. We implemented a case-centered method to estimate a relative risk (RR) for death in days 0 to 30 after vaccination.Deaths due to external causes (accidents, homicides, and suicides) were excluded from the primary analysis. In a secondary analysis, we included all deaths regardless of cause. A team of physicians reviewed available medical records and coroner's reports to confirm cause of death and assess the causal relationship between death and vaccination. RESULTS: Of the 1100 deaths identified during the study period, 76 (7%) occurred 0 to 30 days after vaccination. The relative risks for deaths after any vaccination and influenza vaccination were significantly lower for deaths due to nonexternal causes (RR 0.57, 95% confidence interval [CI] 0.38-0.83, and RR 0.44, 95% CI 0.24-0.80, respectively) and deaths due to all causes (RR 0.72, 95% CI 0.56-0.91, and RR 0.44, 95% CI 0.28-0.65). No other individual vaccines were significantly associated with death. Among deaths reviewed, 1 cause of death was unknown, 25 deaths were due to nonexternal causes, and 34 deaths were due to external causes. The causality assessment found no evidence of a causal association between vaccination and death. CONCLUSIONS: Risk of death was not increased during the 30 days after vaccination, and no deaths were found to be causally associated with vaccination.
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