title: Associations between vaccination and childhood cancers in Texas regions.
abstract: OBJECTIVE
  To determine whether children born in Texas regions with higher vaccination coverage had reduced risk of childhood cancer.
  
  
  METHODS
  The Texas Cancer Registry identified 2800 cases diagnosed from 1995 to 2006 who were (1) born in Texas and (2) diagnosed at ages 2 to 17 years. The state birth certificate data were used to identify 11 200 age- and sex-matched control subjects. A multilevel mixed-effects regression model compared vaccination rates among cases and control subjects at the public health region and county level.
  
  
  RESULTS
  Children born in counties with higher hepatitis B vaccine coverage had lower odds of all cancers combined (OR = 0.81, 95% CI: 0.67 to 0.98) and acute lymphoblastic leukemia (ALL) specifically (OR = 0.63, 95% CI: 0.46 to 0.88). A decreased odds for ALL also was associated at the county level with higher rates of the inactivated poliovirus vaccine (OR = 0.67, 95% CI: 0.49 to 0.92) and 4-3-1-3-3 vaccination series (OR = 0.62, 95% CI: 0.44 to 0.87). Children born in public health regions with higher coverage levels of the Haemophilus influenzae type b-conjugate vaccine had lower odds of ALL (OR: 0.58; 95% CI: 0.42 to 0.82).
  
  
  CONCLUSIONS
  Some common childhood vaccines appear to be protective against ALL at the population level.
authors.affiliation: Division of Epidemiology and Disease Control, The University of Texas School of Public Health, Houston, TX, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Pagaoa
authors.forename: M Fatih
authors.initials: MF
authors.lastname: Okcu
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Bondy
authors.forename: Michael E
authors.initials: ME
authors.lastname: Scheurer
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D018073:Haemophilus Vaccines / Q000627:therapeutic use; D017325:Hepatitis B Vaccines / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D008297:Male; D008495:Medical Oncology / Q000379:methods*; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control*; D016017:Odds Ratio; D010372:Pediatrics / Q000379:methods*; D023321:Poliovirus Vaccines / Q000627:therapeutic use; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000517:prevention & control; D012044:Regression Analysis; D013781:Texas; D014612:Vaccines / Q000009:adverse effects
chemical_list: D018073:Haemophilus Vaccines; D017325:Hepatitis B Vaccines; D023321:Poliovirus Vaccines; D014612:Vaccines