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Childhood vaccinations and risk of asthma

 

作者: FRANK DESTEFANO,   DAVID GU,   PIOTR KRAMARZ,   BENEDICT TRUMAN,   MICHAEL IADEMARCO,   JOHN MULLOOLY,   LISA JACKSON,   ROBERT DAVIS,   STEVEN BLACK,   HENRY SHINEFIELD,   S. MARCY,   JOEL WARD,   ROBERT CHEN,  

 

期刊: The Pediatric Infectious Disease Journal  (OVID Available online 2002)
卷期: Volume 21, issue 6  

页码: 498-504

 

ISSN:0891-3668

 

年代: 2002

 

出版商: OVID

 

关键词: Pertussis vaccine;measles vaccine;hepatitis B vaccine;epidemiology

 

数据来源: OVID

 

摘要:

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) forHaemophilus influenzaetype 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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