title: Comparison of self-reported and recorded vaccinations and health effects in Australian Gulf War veterans.
abstract: BACKGROUND
  Vaccinations, and multiple vaccinations in particular, have been associated with adverse health effects in veterans of the 1990/1991 Gulf War. However, exposure assessment has usually been based on self-report and recall bias may have influenced the results.
  
  
  METHODS
  We investigated agreement between self-reported and recorded vaccinations and the relationship with health status in Australian Gulf War veterans.
  
  
  RESULTS
  Agreement between self-reported and recorded vaccinations was highest for plague (kappa=0.80), and kappa coefficients were greater than 0.60 for polio and 'other unlisted' vaccines, between 0.41 and 0.60 for hepatitis B, hepatitis A, typhoid and pertussis, and less than 0.40 for the other listed vaccines. The associations of increasing number of self-reported vaccinations in dose response relationships with total number of symptoms, functional impairment, and poorer physical health were not observed when based on recorded vaccination data, although the actual difference in estimates was small and statistically significant only for total number of symptoms.
  
  
  CONCLUSIONS
  Vaccinations were not associated with adverse health effects when exposure assessment was based on recorded vaccinations. It would be prudent that future research studies should be based on recorded vaccination data.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia. helen.kelsall@med.monash.edu.au
authors.forename: Helen
authors.initials: H
authors.lastname: Kelsall
authors.forename: Dean
authors.initials: D
authors.lastname: McKenzie
authors.forename: Malcolm
authors.initials: M
authors.lastname: Sim
authors.forename: Karin
authors.initials: K
authors.lastname: Leder
authors.forename: James
authors.initials: J
authors.lastname: Ross
authors.forename: Andrew
authors.initials: A
authors.lastname: Forbes
authors.forename: Jillian
authors.initials: J
authors.lastname: Ikin
mesh_terms: D044362:Australasia; D005260:Female; D047830:Gulf War; D006304:Health Status; D006801:Humans; D008297:Male; D008499:Medical Records; D008889:Military Personnel; D011996:Records; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000009:adverse effects* / Q000706:statistics & numerical data*; D014728:Veterans