title: Mortality rates and cause-of-death patterns in a vaccinated population.
abstract: BACKGROUND
  Determining the baseline mortality rate in a vaccinated population is necessary to be able to identify any unusual increases in deaths following vaccine administration. Background rates are particularly useful during mass immunization campaigns and in the evaluation of new vaccines.
  
  
  OBJECTIVE
  Provide background mortality rates and describe causes of death following vaccination in the Vaccine Safety Datalink (VSD).
  
  
  METHODS
  Analyses were conducted in 2012. Mortality rates were calculated at 0-1 day, 0-7 days, 0-30 days, and 0-60 days following vaccination for deaths occurring between January 1, 2005, and December 31, 2008. Analyses were stratified by age and gender. Causes of death were examined, and findings were compared to National Center for Health Statistics (NCHS) data.
  
  
  RESULTS
  Among 13,033,274 vaccinated people, 15,455 deaths occurred between 0 and 60 days following vaccination. The mortality rate within 60 days of a vaccination visit was 442.5 deaths per 100,000 person-years. Rates were highest in the group aged ≥85 years, and increased from the 0-1-day to the 0-60-day interval following vaccination. Eleven of the 15 leading causes of death in the VSD and NCHS overlap in both systems, and the top four causes of death were the same in both systems.
  
  
  CONCLUSIONS
  VSD mortality rates demonstrate a healthy vaccinee effect, with rates lowest in the days immediately following vaccination, most apparent in the older age groups. The VSD mortality rate is lower than that in the general U.S. population, and the causes of death are similar.
authors.affiliation: CDC, Atlanta, Georgia.
authors.forename: Natalie L
authors.initials: NL
authors.lastname: McCarthy
authors.affiliation: CDC, Atlanta, Georgia.
authors.forename: Eric
authors.initials: E
authors.lastname: Weintraub
authors.affiliation: CDC, Atlanta, Georgia.
authors.forename: Claudia
authors.initials: C
authors.lastname: Vellozzi
authors.affiliation: CDC, Atlanta, Georgia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Duffy
authors.affiliation: CDC, Atlanta, Georgia.
authors.forename: Julianne
authors.initials: J
authors.lastname: Gee
authors.affiliation: Marshfield Clinic Research Foundation, Marshfield, Wisconsin.
authors.forename: James G
authors.initials: JG
authors.lastname: Donahue
authors.affiliation: Group Health Research Institute, Seattle, Washington.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Jackson
authors.affiliation: Harvard Pilgrim Health Care Institute, Boston, Massachusetts.
authors.forename: Grace M
authors.initials: GM
authors.lastname: Lee
authors.affiliation: Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado.
authors.forename: Jason
authors.initials: J
authors.lastname: Glanz
authors.affiliation: Kaiser Permanente Vaccine Study Center, Oakland, Southern California.
authors.forename: Roger
authors.initials: R
authors.lastname: Baxter
authors.affiliation: Kaiser Permanente, Pasadena, California.
authors.forename: Marlene M
authors.initials: MM
authors.lastname: Lugg
authors.affiliation: Kaiser Permanente Northwest, Portland, Oregon.
authors.forename: Allison
authors.initials: A
authors.lastname: Naleway
authors.affiliation: Kaiser Permanente Georgia, Atlanta, Georgia.
authors.forename: Saad B
authors.initials: SB
authors.lastname: Omer
authors.affiliation: Kaiser Permanente Center for Health Research Hawaii, Honolulu, Hawaii.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Nakasato
authors.affiliation: Health Partners Institute for Education and Research, Minneapolis, Minnesota. Electronic address: gvz7@cdc.gov.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Vazquez-Benitez
authors.affiliation: CDC, Atlanta, Georgia.
authors.forename: Frank
authors.initials: F
authors.lastname: DeStefano
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D032541:Mass Vaccination / Q000379:methods*; D008875:Middle Aged; D009026:Mortality; D011159:Population Surveillance; D013997:Time Factors; D014481:United States; D014611:Vaccination / Q000706:statistics & numerical data*; D055815:Young Adult