Kawasaki disease after vaccination: reports to the vaccine adverse event reporting system 1990-2007.
BACKGROUND
Kawasaki disease (KD) is a multisystemic vasculitis primarily affecting children<5 years. A review of RotaTeq (rotavirus vaccine live) clinical trial data revealed higher, though not statistically significantly, KD rates among RotaTeq vaccines than placebo recipients. In June 2007, the RotaTeq label was revised accordingly.


OBJECTIVE
To describe and assess KD reported to Vaccine Adverse Event Reporting System (VAERS) for all US licensed vaccines.


METHODS
We reviewed all KD reports received by VAERS from 1990 through mid-October 2007. Cases were characterized by age, gender, onset interval, and vaccine type. Proportional reporting ratio (PRR) was used to evaluate KD reporting for each vaccine compared with all others. Reporting rates were calculated using number of doses distributed as denominator.


RESULTS
Through October 14, 2007, 107 KD reports were received by VAERS: 26 were categorized as classic cases, 19 atypical, 52 possible, and 10 were noncases. Of the 97 cases, 91% were children<5 years. There was no clustering of onset intervals after day 1 postvaccination. Before the RotaTeq label revision, the KD PRR was elevated only for Pediarix (DTaP, hepB, and IPV combined) but the KD reporting rate for Pediarix (0.59/100,000 person-years) was much lower than the background incidence rate (9-19/100,000 person-years) for children<5 years in the United States. After the revision, reporting of KD for RotaTeq was stimulated but the reporting rate for RotaTeq (1.47/100,000 person-years) was still much lower than the background rate.


CONCLUSIONS
Our review does not suggest an elevated KD risk for RotaTeq or other vaccines. Continued postmarketing monitoring for KD is ongoing.
Hua
Wei
W
Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research (CBER), Food and Drug Administration (FDA), Rockville, MD 20852-1448, USA. wei.hua@fda.hhs.gov
Izurieta
Hector S
HS
Slade
Barbara
B
Belay
Ermias D
ED
Haber
Penina
P
Tiernan
Rosemary
R
Woo
Emily Jane
EJ
Iskander
John
J
Braun
M Miles
MM
Ball
Robert
R
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009080:Mucocutaneous Lymph Node Syndrome / Q000139:chemically induced* / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000009:adverse effects*; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*; D055815:Young Adult
D014612:Vaccines