Risk of hospitalisation with fever following MenB vaccination: self-controlled case series analysis

Heather Murdoch, Lynn Wallace, Jennifer Bishop, Chris Robertson, J Claire Cameron

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

OBJECTIVE: To investigate a possible association between fever admissions and 4 component Meningococcal B (4CMenB).

DESIGN: 4CMenB is given at 8 and 16 weeks in the first year of life. Self-controlled case series using linked routinely collected healthcare data, where the risk period was the 3 days immediately following receipt of a vaccine dose.

PATIENTS: Children aged under 1 year in Scotland preintroduction and postintroduction of 4CMenB vaccine (pre-September 2014 to August 2015 and post-September 2015 to June 2016).

MAIN OUTCOME MEASURES: Hospitalisations for fever attributable to 4CMenB vaccine.

RESULTS: The postintroduction model showed an increased risk in the 3 days after dose 1 (relative incidence (RI), 10.78; 95% CI: 8.31 to 14.00) and dose 3 (RI, 9.80; 95% CI: 7.10 to 13.62), with a smaller increased risk after dose 2 (RI, 2.20; 95% CI: 1.27 to 3.82). The magnitude of these effects was greater than in the preintroduction model. The attributable fractions were 90.7%, 54.8% and 89.7%, equating to 162, 14 and 84 vaccine attributable cases per 100 000 doses, respectively.This is equivalent to 102 extra hospitalisations in Scotland annually, based on a birth cohort of 55 100 and extrapolated to 1430 across the UK based on a birth cohort of 777 165.

CONCLUSION: There is an increased risk of hospital admission with fever within 3 days of the routine childhood immunisations at 8 and 16 weeks following introduction of 4CMenB vaccine. The results indicate that further understanding of the current use of prophylactic paracetamol is needed. Communication to parents and health professionals may also need to be re-examined, and guidance on the use of prophylactic paracetamol reinforced.

LanguageEnglish
Pages894-898
Number of pages5
JournalArchives of Disease in Childhood
Volume102
Issue number10
Early online date20 Sep 2017
DOIs
Publication statusPublished - 1 Oct 2017

Fingerprint

Meningococcal Vaccines
Vaccination
Hospitalization
Fever
Scotland
Acetaminophen
Incidence
Vaccines
Parturition
Immunization
Parents
Communication
Delivery of Health Care
Health

Keywords

  • female
  • fever
  • hospitalization
  • humans
  • infant
  • male
  • meningococcal infections
  • meningococcal vaccines
  • neisseria meningitidis, serogroup b
  • risk
  • Scotland

Cite this

Murdoch, Heather ; Wallace, Lynn ; Bishop, Jennifer ; Robertson, Chris ; Claire Cameron, J. / Risk of hospitalisation with fever following MenB vaccination : self-controlled case series analysis. In: Archives of Disease in Childhood. 2017 ; Vol. 102, No. 10. pp. 894-898.
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abstract = "OBJECTIVE: To investigate a possible association between fever admissions and 4 component Meningococcal B (4CMenB).DESIGN: 4CMenB is given at 8 and 16 weeks in the first year of life. Self-controlled case series using linked routinely collected healthcare data, where the risk period was the 3 days immediately following receipt of a vaccine dose.PATIENTS: Children aged under 1 year in Scotland preintroduction and postintroduction of 4CMenB vaccine (pre-September 2014 to August 2015 and post-September 2015 to June 2016).MAIN OUTCOME MEASURES: Hospitalisations for fever attributable to 4CMenB vaccine.RESULTS: The postintroduction model showed an increased risk in the 3 days after dose 1 (relative incidence (RI), 10.78; 95{\%} CI: 8.31 to 14.00) and dose 3 (RI, 9.80; 95{\%} CI: 7.10 to 13.62), with a smaller increased risk after dose 2 (RI, 2.20; 95{\%} CI: 1.27 to 3.82). The magnitude of these effects was greater than in the preintroduction model. The attributable fractions were 90.7{\%}, 54.8{\%} and 89.7{\%}, equating to 162, 14 and 84 vaccine attributable cases per 100 000 doses, respectively.This is equivalent to 102 extra hospitalisations in Scotland annually, based on a birth cohort of 55 100 and extrapolated to 1430 across the UK based on a birth cohort of 777 165.CONCLUSION: There is an increased risk of hospital admission with fever within 3 days of the routine childhood immunisations at 8 and 16 weeks following introduction of 4CMenB vaccine. The results indicate that further understanding of the current use of prophylactic paracetamol is needed. Communication to parents and health professionals may also need to be re-examined, and guidance on the use of prophylactic paracetamol reinforced.",
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Risk of hospitalisation with fever following MenB vaccination : self-controlled case series analysis. / Murdoch, Heather; Wallace, Lynn; Bishop, Jennifer; Robertson, Chris; Claire Cameron, J.

In: Archives of Disease in Childhood, Vol. 102, No. 10, 01.10.2017, p. 894-898.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Risk of hospitalisation with fever following MenB vaccination

T2 - Archives of Disease in Childhood

AU - Murdoch, Heather

AU - Wallace, Lynn

AU - Bishop, Jennifer

AU - Robertson, Chris

AU - Claire Cameron, J

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2017/10/1

Y1 - 2017/10/1

N2 - OBJECTIVE: To investigate a possible association between fever admissions and 4 component Meningococcal B (4CMenB).DESIGN: 4CMenB is given at 8 and 16 weeks in the first year of life. Self-controlled case series using linked routinely collected healthcare data, where the risk period was the 3 days immediately following receipt of a vaccine dose.PATIENTS: Children aged under 1 year in Scotland preintroduction and postintroduction of 4CMenB vaccine (pre-September 2014 to August 2015 and post-September 2015 to June 2016).MAIN OUTCOME MEASURES: Hospitalisations for fever attributable to 4CMenB vaccine.RESULTS: The postintroduction model showed an increased risk in the 3 days after dose 1 (relative incidence (RI), 10.78; 95% CI: 8.31 to 14.00) and dose 3 (RI, 9.80; 95% CI: 7.10 to 13.62), with a smaller increased risk after dose 2 (RI, 2.20; 95% CI: 1.27 to 3.82). The magnitude of these effects was greater than in the preintroduction model. The attributable fractions were 90.7%, 54.8% and 89.7%, equating to 162, 14 and 84 vaccine attributable cases per 100 000 doses, respectively.This is equivalent to 102 extra hospitalisations in Scotland annually, based on a birth cohort of 55 100 and extrapolated to 1430 across the UK based on a birth cohort of 777 165.CONCLUSION: There is an increased risk of hospital admission with fever within 3 days of the routine childhood immunisations at 8 and 16 weeks following introduction of 4CMenB vaccine. The results indicate that further understanding of the current use of prophylactic paracetamol is needed. Communication to parents and health professionals may also need to be re-examined, and guidance on the use of prophylactic paracetamol reinforced.

AB - OBJECTIVE: To investigate a possible association between fever admissions and 4 component Meningococcal B (4CMenB).DESIGN: 4CMenB is given at 8 and 16 weeks in the first year of life. Self-controlled case series using linked routinely collected healthcare data, where the risk period was the 3 days immediately following receipt of a vaccine dose.PATIENTS: Children aged under 1 year in Scotland preintroduction and postintroduction of 4CMenB vaccine (pre-September 2014 to August 2015 and post-September 2015 to June 2016).MAIN OUTCOME MEASURES: Hospitalisations for fever attributable to 4CMenB vaccine.RESULTS: The postintroduction model showed an increased risk in the 3 days after dose 1 (relative incidence (RI), 10.78; 95% CI: 8.31 to 14.00) and dose 3 (RI, 9.80; 95% CI: 7.10 to 13.62), with a smaller increased risk after dose 2 (RI, 2.20; 95% CI: 1.27 to 3.82). The magnitude of these effects was greater than in the preintroduction model. The attributable fractions were 90.7%, 54.8% and 89.7%, equating to 162, 14 and 84 vaccine attributable cases per 100 000 doses, respectively.This is equivalent to 102 extra hospitalisations in Scotland annually, based on a birth cohort of 55 100 and extrapolated to 1430 across the UK based on a birth cohort of 777 165.CONCLUSION: There is an increased risk of hospital admission with fever within 3 days of the routine childhood immunisations at 8 and 16 weeks following introduction of 4CMenB vaccine. The results indicate that further understanding of the current use of prophylactic paracetamol is needed. Communication to parents and health professionals may also need to be re-examined, and guidance on the use of prophylactic paracetamol reinforced.

KW - female

KW - fever

KW - hospitalization

KW - humans

KW - infant

KW - male

KW - meningococcal infections

KW - meningococcal vaccines

KW - neisseria meningitidis, serogroup b

KW - risk

KW - Scotland

U2 - 10.1136/archdischild-2017-313079

DO - 10.1136/archdischild-2017-313079

M3 - Article

VL - 102

SP - 894

EP - 898

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

SN - 0003-9888

IS - 10

ER -