MMR2 immunization at 4 to 5 years and 10 to 12 years of age

A comparison of adverse clinical events after immunization in the vaccine safety datalink project

Robert Davis, Edgar Marcuse, Steven Black, Henry Shinefield, Ben Givens, Joan Schwalbe, Paula Ray, Robert S. Thompson, Robert Chen, John W. Glasser, Philip H. Rhodes, Emmett Swint, Lisa A. Jackson, William E. Barlow, Virginia H. Immanuel, Patti J. Benson, John P. Mullooly, Lois Drew, Barbara Mendius, Ned Lewis & 12 others Bruce H. Fireman, Joel I. Ward, Connie M. Vadheim, S. Michael Marcy, Jennie Jing, Michael Wulfson, Marlene Lugg, Patricia Osborne, Robert P. Wise, Suresh Rastogi, Peter Patriarca, Vito Caserta

Research output: Contribution to journalArticle

58 Citations (Scopus)

Abstract

Background. The Advisory Committee on Immunization Practices recommends a second dose of measles, mumps, and rubella vaccine (MMR2) at age 4 to 5 years of age, whereas the American Academy of Pediatrics suggests MMR2 immunization at age 11 to 12 years of age. Because there is little information on whether the rate of adverse reactions to MMR2 immunization varies among these two age groups, we took advantage of differing immunization policies at two large HMOs to compare the frequency of clinical events after, and possibly related to, MMR2 immunization. Methods. Information was collected on clinical events plausibly associated to MMR immunization (seizures, pyrexia, malaise/fatigue, nervous/musculoskeletal symptoms, rash, edema, induration/ecchymoses, lymphadenopathy, thrombocytopenia, aseptic meningitis, and joint pain) in two cohorts. At three facilities at Northern California Kaiser (Oakland, CA), 8514 children received MMR2 immunization at age 4 to 6 years of age; at Group Health Cooperative (Seattle, WA) 18 036 children received MMR2 immunization at age 10 to 12 years of age. To account for age-related differences in health care use, within each HMO, clinical events in a 30-day period after immunization were compared with a 30-day period before vaccination. Results. Children 10 to 12 years of age were 50% more likely to have a clinical event after MMR2 immunization than in the period before immunization (odds ratio, 1.45; of age were less likely to have a visit for an event after immunization compared with the period before immunization (odds ratio, 0.64; 95% confidence interval: 0.40,1.01). Conclusions. These results suggest that the risk for clinical events after MMR2 immunizations is greater in the 10- to 12-year age group.

Original languageEnglish (US)
Pages (from-to)767-771
Number of pages5
JournalPediatrics
Volume100
Issue number5
DOIs
StatePublished - Nov 1 1997

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Immunization
Vaccines
Safety
Health Maintenance Organizations
Age Groups
Odds Ratio
Measles-Mumps-Rubella Vaccine
Ecchymosis
Aseptic Meningitis
Arthralgia
Advisory Committees
Exanthema
Thrombocytopenia
Fatigue
Edema
Vaccination
Seizures
Fever
Confidence Intervals
Pediatrics

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

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MMR2 immunization at 4 to 5 years and 10 to 12 years of age : A comparison of adverse clinical events after immunization in the vaccine safety datalink project. / Davis, Robert; Marcuse, Edgar; Black, Steven; Shinefield, Henry; Givens, Ben; Schwalbe, Joan; Ray, Paula; Thompson, Robert S.; Chen, Robert; Glasser, John W.; Rhodes, Philip H.; Swint, Emmett; Jackson, Lisa A.; Barlow, William E.; Immanuel, Virginia H.; Benson, Patti J.; Mullooly, John P.; Drew, Lois; Mendius, Barbara; Lewis, Ned; Fireman, Bruce H.; Ward, Joel I.; Vadheim, Connie M.; Marcy, S. Michael; Jing, Jennie; Wulfson, Michael; Lugg, Marlene; Osborne, Patricia; Wise, Robert P.; Rastogi, Suresh; Patriarca, Peter; Caserta, Vito.

In: Pediatrics, Vol. 100, No. 5, 01.11.1997, p. 767-771.

Research output: Contribution to journalArticle

Davis, R, Marcuse, E, Black, S, Shinefield, H, Givens, B, Schwalbe, J, Ray, P, Thompson, RS, Chen, R, Glasser, JW, Rhodes, PH, Swint, E, Jackson, LA, Barlow, WE, Immanuel, VH, Benson, PJ, Mullooly, JP, Drew, L, Mendius, B, Lewis, N, Fireman, BH, Ward, JI, Vadheim, CM, Marcy, SM, Jing, J, Wulfson, M, Lugg, M, Osborne, P, Wise, RP, Rastogi, S, Patriarca, P & Caserta, V 1997, 'MMR2 immunization at 4 to 5 years and 10 to 12 years of age: A comparison of adverse clinical events after immunization in the vaccine safety datalink project', Pediatrics, vol. 100, no. 5, pp. 767-771. https://doi.org/10.1542/peds.100.5.767
Davis, Robert ; Marcuse, Edgar ; Black, Steven ; Shinefield, Henry ; Givens, Ben ; Schwalbe, Joan ; Ray, Paula ; Thompson, Robert S. ; Chen, Robert ; Glasser, John W. ; Rhodes, Philip H. ; Swint, Emmett ; Jackson, Lisa A. ; Barlow, William E. ; Immanuel, Virginia H. ; Benson, Patti J. ; Mullooly, John P. ; Drew, Lois ; Mendius, Barbara ; Lewis, Ned ; Fireman, Bruce H. ; Ward, Joel I. ; Vadheim, Connie M. ; Marcy, S. Michael ; Jing, Jennie ; Wulfson, Michael ; Lugg, Marlene ; Osborne, Patricia ; Wise, Robert P. ; Rastogi, Suresh ; Patriarca, Peter ; Caserta, Vito. / MMR2 immunization at 4 to 5 years and 10 to 12 years of age : A comparison of adverse clinical events after immunization in the vaccine safety datalink project. In: Pediatrics. 1997 ; Vol. 100, No. 5. pp. 767-771.
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abstract = "Background. The Advisory Committee on Immunization Practices recommends a second dose of measles, mumps, and rubella vaccine (MMR2) at age 4 to 5 years of age, whereas the American Academy of Pediatrics suggests MMR2 immunization at age 11 to 12 years of age. Because there is little information on whether the rate of adverse reactions to MMR2 immunization varies among these two age groups, we took advantage of differing immunization policies at two large HMOs to compare the frequency of clinical events after, and possibly related to, MMR2 immunization. Methods. Information was collected on clinical events plausibly associated to MMR immunization (seizures, pyrexia, malaise/fatigue, nervous/musculoskeletal symptoms, rash, edema, induration/ecchymoses, lymphadenopathy, thrombocytopenia, aseptic meningitis, and joint pain) in two cohorts. At three facilities at Northern California Kaiser (Oakland, CA), 8514 children received MMR2 immunization at age 4 to 6 years of age; at Group Health Cooperative (Seattle, WA) 18 036 children received MMR2 immunization at age 10 to 12 years of age. To account for age-related differences in health care use, within each HMO, clinical events in a 30-day period after immunization were compared with a 30-day period before vaccination. Results. Children 10 to 12 years of age were 50{\%} more likely to have a clinical event after MMR2 immunization than in the period before immunization (odds ratio, 1.45; of age were less likely to have a visit for an event after immunization compared with the period before immunization (odds ratio, 0.64; 95{\%} confidence interval: 0.40,1.01). Conclusions. These results suggest that the risk for clinical events after MMR2 immunizations is greater in the 10- to 12-year age group.",
author = "Robert Davis and Edgar Marcuse and Steven Black and Henry Shinefield and Ben Givens and Joan Schwalbe and Paula Ray and Thompson, {Robert S.} and Robert Chen and Glasser, {John W.} and Rhodes, {Philip H.} and Emmett Swint and Jackson, {Lisa A.} and Barlow, {William E.} and Immanuel, {Virginia H.} and Benson, {Patti J.} and Mullooly, {John P.} and Lois Drew and Barbara Mendius and Ned Lewis and Fireman, {Bruce H.} and Ward, {Joel I.} and Vadheim, {Connie M.} and Marcy, {S. Michael} and Jennie Jing and Michael Wulfson and Marlene Lugg and Patricia Osborne and Wise, {Robert P.} and Suresh Rastogi and Peter Patriarca and Vito Caserta",
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TY - JOUR

T1 - MMR2 immunization at 4 to 5 years and 10 to 12 years of age

T2 - A comparison of adverse clinical events after immunization in the vaccine safety datalink project

AU - Davis, Robert

AU - Marcuse, Edgar

AU - Black, Steven

AU - Shinefield, Henry

AU - Givens, Ben

AU - Schwalbe, Joan

AU - Ray, Paula

AU - Thompson, Robert S.

AU - Chen, Robert

AU - Glasser, John W.

AU - Rhodes, Philip H.

AU - Swint, Emmett

AU - Jackson, Lisa A.

AU - Barlow, William E.

AU - Immanuel, Virginia H.

AU - Benson, Patti J.

AU - Mullooly, John P.

AU - Drew, Lois

AU - Mendius, Barbara

AU - Lewis, Ned

AU - Fireman, Bruce H.

AU - Ward, Joel I.

AU - Vadheim, Connie M.

AU - Marcy, S. Michael

AU - Jing, Jennie

AU - Wulfson, Michael

AU - Lugg, Marlene

AU - Osborne, Patricia

AU - Wise, Robert P.

AU - Rastogi, Suresh

AU - Patriarca, Peter

AU - Caserta, Vito

PY - 1997/11/1

Y1 - 1997/11/1

N2 - Background. The Advisory Committee on Immunization Practices recommends a second dose of measles, mumps, and rubella vaccine (MMR2) at age 4 to 5 years of age, whereas the American Academy of Pediatrics suggests MMR2 immunization at age 11 to 12 years of age. Because there is little information on whether the rate of adverse reactions to MMR2 immunization varies among these two age groups, we took advantage of differing immunization policies at two large HMOs to compare the frequency of clinical events after, and possibly related to, MMR2 immunization. Methods. Information was collected on clinical events plausibly associated to MMR immunization (seizures, pyrexia, malaise/fatigue, nervous/musculoskeletal symptoms, rash, edema, induration/ecchymoses, lymphadenopathy, thrombocytopenia, aseptic meningitis, and joint pain) in two cohorts. At three facilities at Northern California Kaiser (Oakland, CA), 8514 children received MMR2 immunization at age 4 to 6 years of age; at Group Health Cooperative (Seattle, WA) 18 036 children received MMR2 immunization at age 10 to 12 years of age. To account for age-related differences in health care use, within each HMO, clinical events in a 30-day period after immunization were compared with a 30-day period before vaccination. Results. Children 10 to 12 years of age were 50% more likely to have a clinical event after MMR2 immunization than in the period before immunization (odds ratio, 1.45; of age were less likely to have a visit for an event after immunization compared with the period before immunization (odds ratio, 0.64; 95% confidence interval: 0.40,1.01). Conclusions. These results suggest that the risk for clinical events after MMR2 immunizations is greater in the 10- to 12-year age group.

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