Revaccination With Measles-Mumps-Rubella Vaccine and Infectious Disease Morbidity: A Danish Register-based Cohort Study

Signe Sørup, Aksel K.G. Jensen, Peter Aaby, Christine S. Benn

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Background: It has been hypothesized that revaccination with live vaccines is associated with reductions in off-target morbidity and mortality. We examined if revaccination with the live measles, mumps, and rubella vaccine (MMR) is associated with a lower rate of off-target infections. Methods: We performed a register-based nationwide cohort study that included 295559 children born in Denmark from April 2004 to December 2010. The cohort were followed from age 47 months (1 month before turning age 4 years, which is the recommended age of the second MMR [MMR-2]) until age 60 months. In Cox regression, we estimated adjusted incidence rate ratios (aIRRs) of antibiotic prescriptions and hospital admissions for any infection comparing MMR-2 as most recent vaccine with not having MMR-2 as the most recent vaccine. Results: There was no association between MMR-2 and antibiotic prescriptions (aIRR, 1.01; 95% confidence interval [CI], 0.99-1.02). The aIRR for the association between MMR-2 and admissions for infection of any duration was 0.93 (95% CI, 0.88-0.98). For admissions for infection lasting 0 to 1 day, the aIRR was 0.97 (95% CI, 0.90-1.03) compared with the aIRR of 0.84 (95% CI, 0.74-0.95) for admissions for infection lasting 2 days or longer (test for equality of aIRRs, P = .039). Conclusions: In this study, revaccination with MMR appeared safe in relation to off-target infections and was associated with a lower rate of severe off-target infections. More studies of the possible association between revaccination with live attenuated vaccines and off-target infections are needed.

OriginalsprogEngelsk
TidsskriftClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Vol/bind68
Udgave nummer2
Sider (fra-til)282-290
ISSN1058-4838
DOI
StatusUdgivet - 7. jan. 2019

Fingeraftryk

Measles-Mumps-Rubella Vaccine
Secondary Immunization
Cohort Studies
Incidence
Confidence Intervals
Prescriptions
Attenuated Vaccines
Denmark

Citer dette

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abstract = "Background: It has been hypothesized that revaccination with live vaccines is associated with reductions in off-target morbidity and mortality. We examined if revaccination with the live measles, mumps, and rubella vaccine (MMR) is associated with a lower rate of off-target infections. Methods: We performed a register-based nationwide cohort study that included 295559 children born in Denmark from April 2004 to December 2010. The cohort were followed from age 47 months (1 month before turning age 4 years, which is the recommended age of the second MMR [MMR-2]) until age 60 months. In Cox regression, we estimated adjusted incidence rate ratios (aIRRs) of antibiotic prescriptions and hospital admissions for any infection comparing MMR-2 as most recent vaccine with not having MMR-2 as the most recent vaccine. Results: There was no association between MMR-2 and antibiotic prescriptions (aIRR, 1.01; 95{\%} confidence interval [CI], 0.99-1.02). The aIRR for the association between MMR-2 and admissions for infection of any duration was 0.93 (95{\%} CI, 0.88-0.98). For admissions for infection lasting 0 to 1 day, the aIRR was 0.97 (95{\%} CI, 0.90-1.03) compared with the aIRR of 0.84 (95{\%} CI, 0.74-0.95) for admissions for infection lasting 2 days or longer (test for equality of aIRRs, P = .039). Conclusions: In this study, revaccination with MMR appeared safe in relation to off-target infections and was associated with a lower rate of severe off-target infections. More studies of the possible association between revaccination with live attenuated vaccines and off-target infections are needed.",
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Revaccination With Measles-Mumps-Rubella Vaccine and Infectious Disease Morbidity : A Danish Register-based Cohort Study. / Sørup, Signe; Jensen, Aksel K.G.; Aaby, Peter; Benn, Christine S.

I: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, Bind 68, Nr. 2, 07.01.2019, s. 282-290.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Revaccination With Measles-Mumps-Rubella Vaccine and Infectious Disease Morbidity

T2 - A Danish Register-based Cohort Study

AU - Sørup, Signe

AU - Jensen, Aksel K.G.

AU - Aaby, Peter

AU - Benn, Christine S.

PY - 2019/1/7

Y1 - 2019/1/7

N2 - Background: It has been hypothesized that revaccination with live vaccines is associated with reductions in off-target morbidity and mortality. We examined if revaccination with the live measles, mumps, and rubella vaccine (MMR) is associated with a lower rate of off-target infections. Methods: We performed a register-based nationwide cohort study that included 295559 children born in Denmark from April 2004 to December 2010. The cohort were followed from age 47 months (1 month before turning age 4 years, which is the recommended age of the second MMR [MMR-2]) until age 60 months. In Cox regression, we estimated adjusted incidence rate ratios (aIRRs) of antibiotic prescriptions and hospital admissions for any infection comparing MMR-2 as most recent vaccine with not having MMR-2 as the most recent vaccine. Results: There was no association between MMR-2 and antibiotic prescriptions (aIRR, 1.01; 95% confidence interval [CI], 0.99-1.02). The aIRR for the association between MMR-2 and admissions for infection of any duration was 0.93 (95% CI, 0.88-0.98). For admissions for infection lasting 0 to 1 day, the aIRR was 0.97 (95% CI, 0.90-1.03) compared with the aIRR of 0.84 (95% CI, 0.74-0.95) for admissions for infection lasting 2 days or longer (test for equality of aIRRs, P = .039). Conclusions: In this study, revaccination with MMR appeared safe in relation to off-target infections and was associated with a lower rate of severe off-target infections. More studies of the possible association between revaccination with live attenuated vaccines and off-target infections are needed.

AB - Background: It has been hypothesized that revaccination with live vaccines is associated with reductions in off-target morbidity and mortality. We examined if revaccination with the live measles, mumps, and rubella vaccine (MMR) is associated with a lower rate of off-target infections. Methods: We performed a register-based nationwide cohort study that included 295559 children born in Denmark from April 2004 to December 2010. The cohort were followed from age 47 months (1 month before turning age 4 years, which is the recommended age of the second MMR [MMR-2]) until age 60 months. In Cox regression, we estimated adjusted incidence rate ratios (aIRRs) of antibiotic prescriptions and hospital admissions for any infection comparing MMR-2 as most recent vaccine with not having MMR-2 as the most recent vaccine. Results: There was no association between MMR-2 and antibiotic prescriptions (aIRR, 1.01; 95% confidence interval [CI], 0.99-1.02). The aIRR for the association between MMR-2 and admissions for infection of any duration was 0.93 (95% CI, 0.88-0.98). For admissions for infection lasting 0 to 1 day, the aIRR was 0.97 (95% CI, 0.90-1.03) compared with the aIRR of 0.84 (95% CI, 0.74-0.95) for admissions for infection lasting 2 days or longer (test for equality of aIRRs, P = .039). Conclusions: In this study, revaccination with MMR appeared safe in relation to off-target infections and was associated with a lower rate of severe off-target infections. More studies of the possible association between revaccination with live attenuated vaccines and off-target infections are needed.

U2 - 10.1093/cid/ciy433

DO - 10.1093/cid/ciy433

M3 - Journal article

C2 - 29846533

AN - SCOPUS:85059495313

VL - 68

SP - 282

EP - 290

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - 2

ER -