Childhood vaccinations and risk of asthma.
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) for Haemophilus influenzae type 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.


CONCLUSIONS
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.
DeStefano
Frank
F
Centers for Disease Control and Prevention, Atlanta, GA, USA.
Gu
David
D
Kramarz
Piotr
P
Truman
Benedict I
BI
Iademarco
Michael F
MF
Mullooly
John P
JP
Jackson
Lisa A
LA
Davis
Robert L
RL
Black
Steven B
SB
Shinefield
Henry R
HR
Marcy
S Michael
SM
Ward
Joel I
JI
Chen
Robert T
RT
D001249:Asthma / Q000453:epidemiology*; D002648:Child; D015331:Cohort Studies; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage / Q000009:adverse effects; D012307:Risk Factors; D014765:Viral Vaccines / Q000009:adverse effects*
D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D011055:Poliovirus Vaccine, Oral; D014765:Viral Vaccines