Outcome Measures



Contribution to Causality Argument

Kemp et al. (1997)


1,265 children born in 1977; followed through age 16 years (New Zealand)

DTP,* polio, measles by proxy

asthma, other allergic diseases by diary or questionnaire by proxy, and by medical records

Risk ratios for asthma episodes, asthma consults, and allergy consults for immunized children ages 0– 10 years were infinite (95% CI 1.03–infmity) because no events occurred in non-immunized group;

Risk ratios (95% CI), age 0.16 yrs; Asthma episodes: 2.9 (0.8-23.6) Asthma consults: 2.7 (0.7-22.3) Allergy consults: 5.6 (1.0-222.6)

Risk ratios for asthma episodes age 0–10 and measles vaccination: 1.0 (0.9-1.1)

weaknesses in study design include small number of unvaccinated children, marginal significance of results, potential for health care utilization bias; difficulty in adjusting for confounders (due to small number of unvaccinated)

weak evidence relevant to causality; favors no effect of any vaccine.

BCG = Bacille Calmette-Guerin vaccine

DTaP = diphtheria-tetanus-acellular pertussis

DTwP = diphtheria-tetanus-whole-cell pertussis

Hep B = hepatitis B vaccine

Hib = Haemophilus influenzae b vaccine

MMR = measles-mumps-rubella vaccine

HMO: health maintenance organization

NS = not significant

OR = odds ratio

RR = relative risk

CI = confidence interval

*These studies do not specify acellular or whole-cell pertussis vaccine. It is assumed that whole-cell pertussis vaccine is being administered to children in these studies.

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