Sørup S, Benn CS, Poulsen A, Krause TG, Aaby P, Ravn H. Simultaneous vaccination with MMR and DTaP-IPV-Hib and rate of hospital admissions with any infections: A nationwide register based cohort study.
Vaccine 2016;
34:6172-6180. [PMID:
27840013 PMCID:
PMC5142423 DOI:
10.1016/j.vaccine.2016.11.005]
[Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 10/31/2016] [Accepted: 11/01/2016] [Indexed: 11/28/2022]
Abstract
Nationwide retrospective cohort study of Danish children aged 15 months to 4 years.
Comparison of the live MMR + the inactivated DTaP-IPV-Hib vaccine vs MMR alone.
27% higher rate of admissions for lower respiratory infections for MMR + DTaP-IPV-Hib.
No significant association with admissions for other types of infections.
Adjustment for a long range of potential confounders including exact age.
Background
In Denmark, live measles, mumps, and rubella vaccine (MMR) is associated with a reduced risk of infectious disease admissions, particularly for lower respiratory tract infections. In low-income countries, simultaneous vaccination (i.e. vaccination at the same visit) with live and inactivated vaccines may increase child mortality compared with the live vaccine alone. We examined the hypothesis that simultaneous administration of MMR and the inactivated DTaP-IPV-Hib vaccine compared with MMR alone is associated with higher incidence of infectious disease admissions.
Methods
Nationwide, retrospective, register based cohort study of 520,859 children born in Denmark 1997–2006, who were followed from 15 months to 4 years of age. Incidence rate ratios (IRRs) of hospital admissions were estimated by Cox regression and adjusted for background factors including exact age.
Results
By 2 years of age, 4965 children had simultaneous MMR and DTaP-IPV-Hib as their most recent vaccination. Compared with MMR alone, simultaneous administration was associated with a higher rate of lower respiratory tract infections (adjusted incidence rate ratio (IRR), 1.27; 95% confidence interval (CI), 1.13–1.42). There was no effect on other infections. Overall, simultaneous administration was associated with a 7% (95% CI, 0–15%) increase in infectious disease admissions.
Conclusions
Simultaneous administration of MMR and DTaP-IPV-Hib compared with MMR alone may increase the rate of hospital admissions related to lower respiratory tract infections. These findings require replication in other high-income settings.
Collapse