Vaccine adverse events in a safety net healthcare system and a managed care organization
- PMID: 28185740
- PMCID: PMC6432772
- DOI: 10.1016/j.vaccine.2017.01.017
Vaccine adverse events in a safety net healthcare system and a managed care organization
Abstract
Background: The Institute of Medicine, in a 2013 report, recommended that the Vaccine Safety Datalink (VSD) expand collaborations to include more diversity in the study population. Kaiser Permanente Colorado (KPCO), an established VSD site, partnered with Denver Health (DH), an integrated safety net healthcare system, to demonstrate the feasibility of integrating DH data within the VSD. Prior to incorporating the data, we examined the identification of specific vaccine associated adverse events (VAEs) in these two distinct healthcare systems.
Methods: We conducted retrospective cohort analyses within KPCO and DH to compare select VAEs between the two populations. We examined the following associations between January 1, 2004 and December 31, 2013: Measles, Mumps, and Rubella (MMR) vaccine and febrile seizures in children 2years and younger, intussusception after rotavirus vaccine in infants 4-34weeks, syncope after adolescent vaccines (Tetanus, Diphtheria, acellular Pertussis; Meningococcal and Human Papillomavirus) in adolescents 13-17years and medically attended local reactions after pneumococcal polysaccharide (PPSV23) vaccine in adults 65years and older. Both sites used similar data procurement methods and chart review processes.
Results: For seizures after MMR vaccine (KPCO - 3.15vs. DH - 2.97/10,000 doses) and syncope after all adolescent vaccines (KPCO - 3.0vs. DH - 2.37/10,000 doses), the chart confirmed rates were comparable at the two sites. However, for medically attended local reactions after PPSV23, there were differences in chart confirmed rates between the sites (KPCO - 31.65vs. DH - 14.90/10,000 doses). For intussusception after rotavirus vaccine, the number of cases was too low to make a valid comparison (KPCO - 0vs. DH - 0.13/10,000 doses).
Conclusion: We demonstrated that data on important targeted VAEs can be captured at DH and rates appear similar to those at KPCO. Work is ongoing on the optimal approach to assimilate DH data as a potential safety net healthcare system in the VSD.
Keywords: Population surveillance; Safety net health system; Vaccine safety.
Copyright © 2017 Elsevier Ltd. All rights reserved.
Conflict of interest statement
Conflict of interest statement
No conflicts of interest are reported by the authors of this paper.
Similar articles
-
Integration of data from a safety net health care system into the Vaccine Safety Datalink.Vaccine. 2017 Mar 1;35(9):1329-1334. doi: 10.1016/j.vaccine.2017.01.027. Epub 2017 Feb 1. Vaccine. 2017. PMID: 28161424 Free PMC article.
-
Safety of vaccines used for routine immunization in the United States: An updated systematic review and meta-analysis.Vaccine. 2021 Jun 23;39(28):3696-3716. doi: 10.1016/j.vaccine.2021.03.079. Epub 2021 May 25. Vaccine. 2021. PMID: 34049735 Review.
-
Adverse Events After MMR or MMRV Vaccine in Infants Under Nine Months Old.Pediatr Infect Dis J. 2016 Aug;35(8):e253-7. doi: 10.1097/INF.0000000000001201. Pediatr Infect Dis J. 2016. PMID: 27167117 Review.
-
Safety of diphtheria, tetanus, acellular pertussis and inactivated poliovirus (DTaP-IPV) vaccine.Vaccine. 2014 May 23;32(25):3019-24. doi: 10.1016/j.vaccine.2014.03.063. Epub 2014 Mar 31. Vaccine. 2014. PMID: 24699471
-
Vaccine Safety Datalink project: a new tool for improving vaccine safety monitoring in the United States. The Vaccine Safety Datalink Team.Pediatrics. 1997 Jun;99(6):765-73. doi: 10.1542/peds.99.6.765. Pediatrics. 1997. PMID: 9164767
Cited by
-
Vaccines for measles, mumps, rubella, and varicella in children.Cochrane Database Syst Rev. 2021 Nov 22;11(11):CD004407. doi: 10.1002/14651858.CD004407.pub5. Cochrane Database Syst Rev. 2021. PMID: 34806766 Free PMC article. Review.
-
Real-world evidence of quadrivalent meningococcal conjugate vaccine safety in the United States: a systematic review.Hum Vaccin Immunother. 2021 May 4;17(5):1432-1441. doi: 10.1080/21645515.2020.1829412. Epub 2020 Dec 17. Hum Vaccin Immunother. 2021. PMID: 33327853 Free PMC article.
-
Vaccines for measles, mumps, rubella, and varicella in children.Cochrane Database Syst Rev. 2020 Apr 20;4(4):CD004407. doi: 10.1002/14651858.CD004407.pub4. Cochrane Database Syst Rev. 2020. Update in: Cochrane Database Syst Rev. 2021 Nov 22;11:CD004407. doi: 10.1002/14651858.CD004407.pub5. PMID: 32309885 Free PMC article. Updated.
-
Integration of data from a safety net health care system into the Vaccine Safety Datalink.Vaccine. 2017 Mar 1;35(9):1329-1334. doi: 10.1016/j.vaccine.2017.01.027. Epub 2017 Feb 1. Vaccine. 2017. PMID: 28161424 Free PMC article.
References
-
- Committee on the Assessment of Studies of Health Outcomes Related to the Recommended Childhood Immunization Schedule, Board on Population Health and Public Health Practice, Institute of Medicine. The childhood immunization schedule and safety: Stakeholder concerns, scientific evidence, and future studies The National Academies Press; 2013. - PubMed
-
- Chen RT, Glasser JW, Rhodes PH, Davis RL, Barlow WE, Thompson RS, et al. Vaccine Safety Datalink project: a new tool for improving vaccine safety monitoring in the United States. The Vaccine Safety Datalink Team. Pediatrics 1997;99(6):765–73. - PubMed
Publication types
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical