Pertussis Immunization in Infancy and Adolescent Asthma Medication
2014 (English)In: Pediatrics, ISSN 0031-4005, Vol. 134, no 4, 721-728 p.Article in journal (Refereed) Published
Context: Lack of infections might contribute to increased risk of asthma among children according to the ‘hygiene hypothesis’. Childhood immunization may play a causal role in the development of asthma.
Objective: To determine whether pertussis immunization in infancy is associated with asthma medication in adolescence.
Design, Settings and Participants: After 14 years of no general pertussis vaccination, almost 80,000 children were immunized for pertussis during a 12-month period in a vaccination trial. They were compared with almost 100,000 non-vaccinated children born during a 6-month period before and after the vaccination trial in a Swedish national cohort study. Information concerning dispensed prescribed asthma medication for each individual in the cohort during 2008–2010 was obtained from the National Prescription database. Multivariable regression models were used to calculate the effect size of vaccination on dispensed asthma medication (Odds ratios and 95% confidence intervals), both in an intent-to-treat model as well as per protocol. The large study size also enabled us to detect very small effects.
Main Outcome Measure: Dispensed prescribed asthma medication at the age of 15 years occurring after pertussis immunization in infancy.
Results: No statistically significant effect of vaccination was found, regardless of vaccination schedule or vaccine type. The prevalence rates of any dispensed anti-inflammatory medication or any asthma medication at 15 years of age were 4.6% and 7.0%, respectively. The crude odds ratios (OR) for any asthma medication and anti-inflammatory treatment in pertussis-vaccinated children after intent-to-treat analysis were 0.97 (95% CI 0.93 – 1.00) and 0.94 (0.90 – 0.98),respectively. Corresponding adjusted ORs were 0.99 (0.95 – 1.03) and 0.97 (0.92 – 1.01),respectively. Similar ORs were found after per-protocol analysis.
Conclusion: Pertussis immunization in infancy does not increase the risk of asthma medication in adolescents. Our study presents evidence that pertussis immunization in early childhood can be considered safe with respect to long-term development of asthma.
Place, publisher, year, edition, pages
APP Journals & Periodicals , 2014. Vol. 134, no 4, 721-728 p.
IdentifiersURN: urn:nbn:se:liu:diva-85157DOI: 10.1542/peds.2014-0723ISI: 000343140500055OAI: oai:DiVA.org:liu-85157DiVA: diva2:565597
On the day of the defence date the status of this article was Manuscript and the title was Does pertussis in infancy increase the risk of asthma medication in adolescents?.2012-11-072012-11-072015-03-30Bibliographically approved