Resumen
Objectives: Children with epilepsy are at increased risk of complications from vaccine-preventable infections, yet information on vaccine coverage in these children is scarce. We aimed to compare vaccine coverage among children with epilepsy to children without epilepsy. Study design: We conducted a retrospective cohort study including all 2005–2013 births in Manitoba and Ontario, Canada, creating two cohorts: 2-year-olds and 7-year-olds (followed to age 2 and 7 years). We split each cohort into epilepsy and non-epilepsy subcohorts. We assessed vaccination coverage based on provincial schedules and determined timeliness of MMR (measles, mumps, rubella) dose 1 (recommended at 12 months) and DTaP (diphtheria, tetanus, pertussis) dose 4 (recommended at 18 months). We used logistic regression to calculate adjusted odds ratios (aORs) of the association between epilepsy and vaccination, combining both provincial estimates using random effects meta-analysis. Results: We included 16,558 2-year-olds (Manitoba, 653; Ontario, 15,905) and 13,004 7-year-olds (Manitoba, 483; Ontario, 12,521) with epilepsy. At age 2 years, the aOR for up-to-date vaccination among children with versus without epilepsy was 0.9 (95% confidence interval 0.8–1.1); at age 7 years it was 1.0 (0.9–1.1). Infants diagnosed with epilepsy before age 6 months were less likely to be up-to-date at age 2 years (0.9; 0.8–0.9), although this difference disappeared by age 7 years. Vaccine timeliness was similar between children with and without epilepsy for MMR dose 1 and DTaP dose 4. Conclusions: Overall, this study suggests that children with epilepsy are not significantly under-vaccinated compared to their peers without epilepsy. As children with epilepsy are at a higher risk of complications from vaccine-preventable diseases, vaccination in children with epilepsy should be optimized, especially early in life, as these children may not be able to rely on herd protection.
| Idioma original | English |
|---|---|
| Páginas (desde-hasta) | 2117-2123 |
| Número de páginas | 7 |
| Publicación | Vaccine |
| Volumen | 39 |
| N.º | 15 |
| DOI | |
| Estado | Published - abr. 8 2021 |
Nota bibliográfica
Funding Information:The authors acknowledge Natalie Giorgis (Canadian Center for Vaccinology) for expert technical assistance. The authors acknowledge the Manitoba Centre for Health Policy for use of data contained in the Manitoba Population Research Data Repository under project # 2017-018 (HIPC # 2017/2018-01, REB # HS20623 (H2017:100)). The results and conclusions are those of the authors and no official endorsement by the Manitoba Centre for Health Policy, Manitoba Health, ICES, Ontario MOHLTC, or other data providers is intended or should be inferred. Manitoba data used in this study are from the Manitoba Population Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health and the Winnipeg Regional Health Authority. In Ontario, this study used datasets linked together using unique coded identifiers at ICES which were analysed within the ICES secure computing infrastructure. We acknowledge the support of ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and/or information compiled and provided by CIHI. However, the analyses, conclusions, opinions and statements expressed in the material are those of the author(s), and not necessarily those of CIHI. The data used in this article was derived from administrative health and social data as a secondary use. The data was provided under specific data sharing agreements only for approved use at Manitoba Centre for Health Policy (MCHP) and ICES. The original source data is not owned by the researchers or MCHP or ICES and as such cannot be provided to a public repository. Where necessary, source data specific to this article or project may be reviewed at MCHP or ICES with the consent of the original data providers, along with the required privacy and ethical review bodies. C.H.R. has received an unrestricted research grant from Pfizer for an unrelated study. K.A.T. has received research support from Pfizer and GlaxoSmithKline and consultancy fees from Pfizer outside the submitted work. S.M.M. has received unrestricted research grants from Merck, GlaxoSmithKline, Sanofi Pasteur, Pfizer and Roche-Assurex for unrelated studies. SMM has received fees as an advisory board member for GlaxoSmithKline, Merck, Pfizer, Sanofi Pasteur and Seqirus. None of the other authors has any conflicts of interest to disclose. This study was funded by the Public Health Agency of Canada and Canadian Institutes of Health Research through the Canadian Immunization Research Network. This study was also supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). SMM's work is supported, in part, by funding from the Canada Research Chair Program. CHR, PB, SLD, BS, KW, SMM, KAT, and SH conceptualized and designed the study. GP and JD performed the data analysis. CHR and SH supervised and assisted with data analysis. CHR, SLD, SEW, KW, SMM, KAT, and SH interpreted the data. CHR, KAT, and SH wrote the manuscript. All authors critically revised the manuscript for intellectual content and approved the final draft for submission.
Publisher Copyright:
© 2021
ASJC Scopus Subject Areas
- Molecular Medicine
- General Immunology and Microbiology
- General Veterinary
- Public Health, Environmental and Occupational Health
- Infectious Diseases
PubMed: MeSH publication types
- Journal Article
- Meta-Analysis
- Research Support, Non-U.S. Gov't
ODS de las Naciones Unidas
Este resultado contribuye a los siguientes Objetivos de Desarrollo Sostenible
