CDC funded study: 1.3 X Asthma risk if vaccination contained aluminum
Association Between Aluminum Exposure From Vaccines Before Age 24 Months and Persistent Asthma at Age 24 to 59 Months
Academic Pediatrics 2022;XX:XX-XX
Matthew F. Daley, MD; Liza M. Reifler, MPH; Jason M. Glanz, PhD; Simon J. Hambidge, MD, PhD; Darios Getahun, MD, PhD; Stephanie A. Irving, MHS; James D. Nordin, MD, MPH; David L. McClure, PhD; Nicola P. Klein, MD, PhD; Michael L. Jackson, PhD, MPH; Satoshi Kamidani, MD; Jonathan Duffy, MD, MPH; Frank DeStefano, MD
From the Institute for Health Research, Kaiser Permanente Colorado (MF Daley, LM Reifler, and JM Glanz), Aurora, Colo; Department of Pediatrics, University of Colorado School of Medicine (MF Daley and SJ Hambidge), Aurora, Colo; Colorado School of Public Health (JM Glanz), Aurora, Colo; Community Health Services, Denver Health (SJ Hambidge), Denver, Colo; Department of Research and Evaluation, Kaiser Permanente Southern California (D Getahun), Pasadena, Calif; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine (D Getahun), Pasadena, Calif; Center for Health Research, Kaiser Permanente Northwest (SA Irving), Portland, Ore; HealthPartners Institute (JD Nordin), Minneapolis, Minn; Marshfield Clinic Research Institute (DL McClure), Marshfield, Wis; Kaiser Permanente Vaccine Study Center, Kaiser Permanente Northern California (NP Klein), Oakland, Calif; Kaiser Permanente Washington Health Research Institute (ML Jackson), Seattle, Wash; Center for Childhood Infections and Vaccines of Children’s Healthcare of Atlanta and Department of Pediatrics, Emory University School of Medicine (S Kamidani), Atlanta, Ga; and Immunization Safety Office, Centers for Disease Control and Prevention (S Kamidani, J Duffy, and F DeStefano), Atlanta, Ga The authors have no conflicts of interest relevant to this article to disclose.
Address correspondence to Matthew F Daley, MD, Institute for Health Research, Kaiser Permanente Colorado, 2550 S. Parker Rd, Suite Q2 200, Aurora, cO 80014 (e-mail: [email protected]).
OBJECTIVE: To assess the association between cumulative aluminum exposure from vaccines before age 24 months and persistent asthma at age 24 to 59 months.
Methods: A retrospective cohort study was conducted in the Vaccine Safety Datalink (VSD). Vaccination histories were used to calculate cumulative vaccine-associated aluminum in milligrams (mg). The persistent asthma definition required one inpatient or 2 outpatient asthma encounters, and >2 long-term asthma control medication dispenses. Cox proportional hazard models were used to evaluate the association between aluminum exposure and asthma incidence, stratified by eczema presence/absence. Adjusted hazard ratios (aHR) and 95% confidence intervals (CI) per 1 mg increase in aluminum exposure were calculated, adjusted for birth month/year, sex, race/ethnicity, VSD site, prematurity, medical complexity, food allergy, severe bronchiolitis, and health care utilization.
RESULTS: The cohort comprised 326,991 children, among whom 14,337 (4.4%) had eczema. For children with and without eczema, the mean (standard deviation [SD]) vaccine-associated aluminum exposure was 4.07 mg (SD 0.60) and 3.98 mg (SD 0.72), respectively. Among children with and without eczema, 6.0% and 2.1%, respectively, developed persistent asthma. Among children with eczema, vaccine-associated aluminum was positively associated with persistent asthma (aHR 1.26 per 1 mg increase in aluminum, 95% CI 1.07, 1.49); a positive association was also detected among children without eczema (aHR 1.19, 95% CI 1.14, 1.25).
CONCLUSION: In a large observational study, a positive association was found between vaccine-related aluminum exposure and persistent asthma. While recognizing the small effect sizes identified and the potential for residual confounding, additional investigation of this hypothesis appears warranted.
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