title: The relationship between vaccine refusal and self-report of atopic disease in children.
abstract: BACKGROUND
  In the last 3 decades, there has been an unexplained increase in the prevalence of asthma and hay fever.
  
  
  OBJECTIVE
  We sought to determine whether there is an association between childhood vaccination and atopic diseases, and we assessed the self-reported prevalence of atopic diseases in a population that included a large number of families not vaccinating their children.
  
  
  METHODS
  Surveys were mailed to 2964 member households of the National Vaccine Information Center, which represents people concerned about vaccine safety, to ascertain vaccination and atopic disease status.
  
  
  RESULTS
  The data included 515 never vaccinated, 423 partially vaccinated, and 239 completely vaccinated children. In multiple regression analyses there were significant ( P < .0005) and dose-dependent negative relationships between vaccination refusal and self-reported asthma or hay fever only in children with no family history of the condition and, for asthma, in children with no exposure to antibiotics during infancy. Vaccination refusal was also significantly ( P < .005) and negatively associated with self-reported eczema and current wheeze. A sensitivity analysis indicated that substantial biases would be required to overturn the observed associations.
  
  
  CONCLUSIONS
  Parents who refuse vaccinations reported less asthma and allergies in their unvaccinated children. Although this relationship was independent of measured confounders, it could be due to differences in other unmeasured lifestyle factors or systematic bias. Further research is needed to verify these results and investigate which exposures are driving the associations between vaccination refusal and allergic disease. The known benefits of vaccination currently outweigh the unproved risk of allergic disease.
authors.affiliation: Division of Allergy, Pulmonary and Critical Care Medicine, School of Medicine, T-1218 Medical Center North, 1161 21st Avenue South, Nashville, TN 37232-2650, USA. Rachel.Enriquez@vanderbilt.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Enriquez
authors.forename: Whitney
authors.initials: W
authors.lastname: Addington
authors.forename: Faith
authors.initials: F
authors.lastname: Davis
authors.forename: Sally
authors.initials: S
authors.lastname: Freels
authors.forename: C Lucy
authors.initials: CL
authors.lastname: Park
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Hershow
authors.forename: Victoria
authors.initials: V
authors.lastname: Persky
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D015995:Prevalence; D016312:Treatment Refusal; D014611:Vaccination / Q000009:adverse effects* / Q000706:statistics & numerical data