Does influenza vaccination exacerbate asthma? Analysis of a large cohort of children with asthma. Vaccine Safety Datalink Team.
BACKGROUND
Although influenza vaccination is recommended for children with asthma, only a minority are vaccinated. One reason for low influenza vaccine coverage among children with asthma may be concern that influenza vaccination may induce an exacerbation of asthma.


OBJECTIVE
To evaluate the safety of influenza vaccination in children with asthma, we studied the incidence of hospitalizations and emergency department visits for asthma following influenza vaccination.


METHODS
Retrospective cohort study-analysis of population-based computerized medical and vaccination records.


METHODS
: Four large health maintenance organizations on the West Coast of the United States.


METHODS
Children with asthma 1 through 6 years of age, identified by search of computerized databases of medical encounters and pharmacy prescriptions.


METHODS
Exacerbations of asthma.


RESULTS
In unadjusted analyses vaccination was associated with high rates of asthma exacerbations. However, after adjusting for asthma severity using a self-control method, the incidence rate ratios of asthma exacerbations after vaccination were 0.58 (95% confidence interval, 0.36-0.95), 0.74 (95% confidence interval, 0.47-1.17), and 0.98 (95% confidence interval, 0.76-1.27) during the 3 influenza seasons.


CONCLUSIONS
After controlling for asthma severity, we found that influenza vaccination does not result in acute asthma exacerbations in children. Concern about possible exacerbation of asthma is not a valid reason to not vaccinate children with asthma against influenza.
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. pdk3@cdc.gov
P
P
Kramarz
F
F
DeStefano
P M
PM
Gargiullo
R L
RL
Davis
R T
RT
Chen
J P
JP
Mullooly
S B
SB
Black
H R
HR
Shinefield
K
K
Bohlke
J I
JI
Ward
M S
MS
Marcy
D001249:Asthma / Q000453:epidemiology / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007252:Influenza Vaccines / Q000009:adverse effects*; D008297:Male; D012189:Retrospective Studies
D007252:Influenza Vaccines