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Multicenter Study
. 2016 Mar;137(3):e20152970.
doi: 10.1542/peds.2015-2970. Epub 2016 Feb 1.

Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults

Natalie L McCarthy  1 , Julianne Gee  2 , Lakshmi Sukumaran  3 , Eric Weintraub  2 , Jonathan Duffy  2 , Elyse O Kharbanda  4 , Roger Baxter  5 , Stephanie Irving  6 , Jennifer King  7 , Matthew F Daley  8 , Rulin Hechter  9 , Michael M McNeil  2
Affiliations
Multicenter Study

Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults

Natalie L McCarthy et al. Pediatrics. 2016 Mar.

Abstract

Objective: This study evaluates the potential association of vaccination and death in the Vaccine Safety Datalink (VSD).

Methods: The study cohort included individuals ages 9 to 26 years with deaths between January 1, 2005, and December 31, 2011. We implemented a case-centered method to estimate a relative risk (RR) for death in days 0 to 30 after vaccination.Deaths due to external causes (accidents, homicides, and suicides) were excluded from the primary analysis. In a secondary analysis, we included all deaths regardless of cause. A team of physicians reviewed available medical records and coroner's reports to confirm cause of death and assess the causal relationship between death and vaccination.

Results: Of the 1100 deaths identified during the study period, 76 (7%) occurred 0 to 30 days after vaccination. The relative risks for deaths after any vaccination and influenza vaccination were significantly lower for deaths due to nonexternal causes (RR 0.57, 95% confidence interval [CI] 0.38-0.83, and RR 0.44, 95% CI 0.24-0.80, respectively) and deaths due to all causes (RR 0.72, 95% CI 0.56-0.91, and RR 0.44, 95% CI 0.28-0.65). No other individual vaccines were significantly associated with death. Among deaths reviewed, 1 cause of death was unknown, 25 deaths were due to nonexternal causes, and 34 deaths were due to external causes. The causality assessment found no evidence of a causal association between vaccination and death.

Conclusions: Risk of death was not increased during the 30 days after vaccination, and no deaths were found to be causally associated with vaccination.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

FINANCIAL DISCLOSURE: Dr Baxter has received research grants from Merck, Sanofi Pasteur, GSK, Novartis, and MedImmune; Dr Hechter receives research support from GlaxoSmithKline; and the other authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

FIGURE 1. Causes of death for deaths occurring on days 0 to 30 after vaccination among individuals 9 to 26 years of age in the VSD, 2005 to 2011. aCause and date of death derived from state data. bAddison disease, Rett syndrome, cerebral palsy, Takayasu disease, aplastic anemia, grand mal seizure, diabetes, obstetric cause, congenital malformation of heart, septic shock, and morbid obesity.
FIGURE 1
Causes of death for deaths occurring on days 0 to 30 after vaccination among individuals 9 to 26 years of age in the VSD, 2005 to 2011. aCause and date of death derived from state data. bAddison disease, Rett syndrome, cerebral palsy, Takayasu disease, aplastic anemia, grand mal seizure, diabetes, obstetric cause, congenital malformation of heart, septic shock, and morbid obesity.
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