Measles, mumps and rubella vs diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b as the most recent vaccine and risk of early 'childhood asthma'

Andreas Rieckmann, Ann Hærskjold, Christine Stabell Benn, Peter Aaby, Theis Lange, Signe Sørup

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

BACKGROUND AND OBJECTIVE: Live vaccines may have beneficial non-specific effects. We tested whether the live measles, mumps and rubella (MMR) vaccine compared with the non-live diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b (DTaP-IPV-Hib) vaccine as the most recent vaccine was associated with less childhood asthma and fewer acute hospital contacts for childhood asthma among boys and girls. METHODS: This study is a nationwide register-based cohort study of 338 761 Danish children born between 1999 and 2006. We compared (i) the incidence of first-registered childhood asthma based on hospital contacts and drug prescriptions and (ii) the incidence of severe asthma defined as acute hospital contacts for childhood asthma between the ages of 15 and 48 months among children whose last received vaccine was three doses of DTaP-IPV-Hib and then MMR with children whose last received vaccine was three doses of DTaP-IPV-Hib. RESULTS: For boys, following the recommended vaccine schedule of MMR after DTaP-IPV-Hib3 compared with DTaP-IPV-Hib3 as the last received vaccine, MMR was associated with 8.1 (95% confidence interval 3.9-12.3) fewer childhood asthma cases per 1000 boys, corresponding to 10% (5-15%) reduction in the cumulative incidence of childhood asthma. MMR, when given last, was also associated with 16.3 (95% confidence interval 12.7-20.0) fewer acute hospital admissions for childhood asthma per 1000 boys, corresponding to a 27% (22-31%) reduction in the cumulative incidence. No associations were seen for girls. CONCLUSION: MMR may have a protective effect against childhood asthma for boys. This calls for an understanding of whether non-specific effects of vaccines can be used to optimize our vaccine programmes.

OriginalsprogEngelsk
TidsskriftInternational Journal of Epidemiology
Vol/bind48
Udgave nummer6
Sider (fra-til)2026-2038
ISSN0300-5771
DOI
StatusUdgivet - 1. dec. 2019

Fingeraftryk

Haemophilus influenzae type b
Mumps
Diphtheria
Whooping Cough
Measles
Measles-Mumps-Rubella Vaccine
Incidence
Confidence Intervals
Cohort Studies

Citer dette

@article{73f35b3f758f4368bb7bd30beed51ed3,
title = "Measles, mumps and rubella vs diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b as the most recent vaccine and risk of early 'childhood asthma'",
abstract = "BACKGROUND AND OBJECTIVE: Live vaccines may have beneficial non-specific effects. We tested whether the live measles, mumps and rubella (MMR) vaccine compared with the non-live diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b (DTaP-IPV-Hib) vaccine as the most recent vaccine was associated with less childhood asthma and fewer acute hospital contacts for childhood asthma among boys and girls. METHODS: This study is a nationwide register-based cohort study of 338 761 Danish children born between 1999 and 2006. We compared (i) the incidence of first-registered childhood asthma based on hospital contacts and drug prescriptions and (ii) the incidence of severe asthma defined as acute hospital contacts for childhood asthma between the ages of 15 and 48 months among children whose last received vaccine was three doses of DTaP-IPV-Hib and then MMR with children whose last received vaccine was three doses of DTaP-IPV-Hib. RESULTS: For boys, following the recommended vaccine schedule of MMR after DTaP-IPV-Hib3 compared with DTaP-IPV-Hib3 as the last received vaccine, MMR was associated with 8.1 (95{\%} confidence interval 3.9-12.3) fewer childhood asthma cases per 1000 boys, corresponding to 10{\%} (5-15{\%}) reduction in the cumulative incidence of childhood asthma. MMR, when given last, was also associated with 16.3 (95{\%} confidence interval 12.7-20.0) fewer acute hospital admissions for childhood asthma per 1000 boys, corresponding to a 27{\%} (22-31{\%}) reduction in the cumulative incidence. No associations were seen for girls. CONCLUSION: MMR may have a protective effect against childhood asthma for boys. This calls for an understanding of whether non-specific effects of vaccines can be used to optimize our vaccine programmes.",
keywords = "Asthma, asthma, heterologous, immunity, immunization, infant, measles, mumps and rubella vaccine, non-specific effects of vaccines, trained innate immunity, vaccine sequence",
author = "Andreas Rieckmann and Ann H{\ae}rskjold and Benn, {Christine Stabell} and Peter Aaby and Theis Lange and Signe S{\o}rup",
year = "2019",
month = "12",
day = "1",
doi = "10.1093/ije/dyz062",
language = "English",
volume = "48",
pages = "2026--2038",
journal = "International Journal of Epidemiology",
issn = "0300-5771",
publisher = "Heinemann",
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Measles, mumps and rubella vs diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b as the most recent vaccine and risk of early 'childhood asthma'. / Rieckmann, Andreas; Hærskjold, Ann; Benn, Christine Stabell; Aaby, Peter; Lange, Theis; Sørup, Signe.

I: International Journal of Epidemiology, Bind 48, Nr. 6, 01.12.2019, s. 2026-2038.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Measles, mumps and rubella vs diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b as the most recent vaccine and risk of early 'childhood asthma'

AU - Rieckmann, Andreas

AU - Hærskjold, Ann

AU - Benn, Christine Stabell

AU - Aaby, Peter

AU - Lange, Theis

AU - Sørup, Signe

PY - 2019/12/1

Y1 - 2019/12/1

N2 - BACKGROUND AND OBJECTIVE: Live vaccines may have beneficial non-specific effects. We tested whether the live measles, mumps and rubella (MMR) vaccine compared with the non-live diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b (DTaP-IPV-Hib) vaccine as the most recent vaccine was associated with less childhood asthma and fewer acute hospital contacts for childhood asthma among boys and girls. METHODS: This study is a nationwide register-based cohort study of 338 761 Danish children born between 1999 and 2006. We compared (i) the incidence of first-registered childhood asthma based on hospital contacts and drug prescriptions and (ii) the incidence of severe asthma defined as acute hospital contacts for childhood asthma between the ages of 15 and 48 months among children whose last received vaccine was three doses of DTaP-IPV-Hib and then MMR with children whose last received vaccine was three doses of DTaP-IPV-Hib. RESULTS: For boys, following the recommended vaccine schedule of MMR after DTaP-IPV-Hib3 compared with DTaP-IPV-Hib3 as the last received vaccine, MMR was associated with 8.1 (95% confidence interval 3.9-12.3) fewer childhood asthma cases per 1000 boys, corresponding to 10% (5-15%) reduction in the cumulative incidence of childhood asthma. MMR, when given last, was also associated with 16.3 (95% confidence interval 12.7-20.0) fewer acute hospital admissions for childhood asthma per 1000 boys, corresponding to a 27% (22-31%) reduction in the cumulative incidence. No associations were seen for girls. CONCLUSION: MMR may have a protective effect against childhood asthma for boys. This calls for an understanding of whether non-specific effects of vaccines can be used to optimize our vaccine programmes.

AB - BACKGROUND AND OBJECTIVE: Live vaccines may have beneficial non-specific effects. We tested whether the live measles, mumps and rubella (MMR) vaccine compared with the non-live diphtheria-tetanus-acellular-pertussis-inactivated-polio-Haemophilus influenzae type b (DTaP-IPV-Hib) vaccine as the most recent vaccine was associated with less childhood asthma and fewer acute hospital contacts for childhood asthma among boys and girls. METHODS: This study is a nationwide register-based cohort study of 338 761 Danish children born between 1999 and 2006. We compared (i) the incidence of first-registered childhood asthma based on hospital contacts and drug prescriptions and (ii) the incidence of severe asthma defined as acute hospital contacts for childhood asthma between the ages of 15 and 48 months among children whose last received vaccine was three doses of DTaP-IPV-Hib and then MMR with children whose last received vaccine was three doses of DTaP-IPV-Hib. RESULTS: For boys, following the recommended vaccine schedule of MMR after DTaP-IPV-Hib3 compared with DTaP-IPV-Hib3 as the last received vaccine, MMR was associated with 8.1 (95% confidence interval 3.9-12.3) fewer childhood asthma cases per 1000 boys, corresponding to 10% (5-15%) reduction in the cumulative incidence of childhood asthma. MMR, when given last, was also associated with 16.3 (95% confidence interval 12.7-20.0) fewer acute hospital admissions for childhood asthma per 1000 boys, corresponding to a 27% (22-31%) reduction in the cumulative incidence. No associations were seen for girls. CONCLUSION: MMR may have a protective effect against childhood asthma for boys. This calls for an understanding of whether non-specific effects of vaccines can be used to optimize our vaccine programmes.

KW - Asthma

KW - asthma

KW - heterologous

KW - immunity

KW - immunization

KW - infant

KW - measles

KW - mumps and rubella vaccine

KW - non-specific effects of vaccines

KW - trained innate immunity

KW - vaccine sequence

U2 - 10.1093/ije/dyz062

DO - 10.1093/ije/dyz062

M3 - Journal article

C2 - 31062020

AN - SCOPUS:85077176120

VL - 48

SP - 2026

EP - 2038

JO - International Journal of Epidemiology

JF - International Journal of Epidemiology

SN - 0300-5771

IS - 6

ER -