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  • American Academy of Pediatrics (AAP)  (16)
  • 1
    Online Resource
    Online Resource
    Seasonal Effectiveness of Live Attenuated and Inactivated Influenza Vaccine
    American Academy of Pediatrics (AAP) ; 2016
    In:  Pediatrics Vol. 137, No. 2 ( 2016-02-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 137, No. 2 ( 2016-02-01)
    Abstract: Few observational studies have evaluated the relative effectiveness of live attenuated (LAIV) and inactivated (IIV) influenza vaccines against medically attended laboratory-confirmed influenza. METHODS: We analyzed US Influenza Vaccine Effectiveness Network data from participants aged 2 to 17 years during 4 seasons (2010–2011 through 2013–2014) to compare relative effectiveness of LAIV and IIV against influenza-associated illness. Vaccine receipt was confirmed via provider/electronic medical records or immunization registry. We calculated the ratio (odds) of influenza-positive to influenza-negative participants among those age-appropriately vaccinated with either LAIV or IIV for the corresponding season. We examined relative effectiveness of LAIV and IIV by using adjusted odds ratios (ORs) and 95% confidence intervals (CIs) from logistic regression. RESULTS: Of 6819 participants aged 2 to 17 years, 2703 were age-appropriately vaccinated with LAIV (n = 637) or IIV (n = 2066). Odds of influenza were similar for LAIV and IIV recipients during 3 seasons (2010–2011 through 2012–2013). In 2013–2014, odds of influenza were significantly higher among LAIV recipients compared with IIV recipients 2 to 8 years old (OR 5.36; 95% CI, 2.37 to 12.13). Participants vaccinated with LAIV or IIV had similar odds of illness associated with influenza A/H3N2 or B. LAIV recipients had greater odds of illness due to influenza A/H1N1pdm09 in 2010–2011 and 2013–2014. CONCLUSIONS: We observed lower effectiveness of LAIV compared with IIV against influenza A/H1N1pdm09 but not A(H3N2) or B among children and adolescents, suggesting poor performance related to the LAIV A/H1N1pdm09 viral construct.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2015-3279
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2016
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  • 2
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    Near Real-Time Surveillance to Assess the Safety of the 9-Valent Human Papillomavirus Vaccine
    American Academy of Pediatrics (AAP) ; 2019
    In:  Pediatrics Vol. 144, No. 6 ( 2019-12-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 144, No. 6 ( 2019-12-01)
    Abstract: Human papillomavirus is the most common sexually transmitted infection in the United States and causes certain anogenital and oropharyngeal cancers. The 9-valent human papillomavirus vaccine (9vHPV) provides protection against additional types not included in the quadrivalent vaccine. We conducted near real-time vaccine safety surveillance for 24 months after the vaccine became available in the Vaccine Safety Datalink. METHODS: Immunizations and adverse events were extracted weekly from October 2015 to October 2017 from standardized data files for persons 9 to 26 years old at 6 Vaccine Safety Datalink sites. Prespecified adverse events included anaphylaxis, allergic reaction, appendicitis, Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, injection site reaction, pancreatitis, seizure, stroke, syncope, and venous thromboembolism. The observed and expected numbers of events after 9vHPV were compared weekly by using sequential methods. Both historical and concurrent comparison groups were used to identify statistical signals for adverse events. Unexpected signals were investigated by medical record review and/or additional analyses. RESULTS: During 105 weeks of surveillance, 838 991 doses of 9vHPV were administered. We identified unexpected statistical signals for 4 adverse events: appendicitis among boys 9 to 17 years old after dose 3; pancreatitis among men 18 to 26 years old; and allergic reactions among girls 9 to 17 years old and women 18 to 26 years old after dose 2. On further evaluation, which included medical record review, temporal scan analysis, and additional epidemiological analyses, we did not confirm signals for any adverse events. CONCLUSIONS: After 2 years of near real-time surveillance of 9vHPV and several prespecified adverse events, no new safety concerns were identified.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2019-1808
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2019
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  • 3
    Online Resource
    Online Resource
    Risk of Immune Thrombocytopenic Purpura After Measles-Mumps-Rubella Immunization in Children
    American Academy of Pediatrics (AAP) ; 2008
    In:  Pediatrics Vol. 121, No. 3 ( 2008-03-01), p. e687-e692
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 121, No. 3 ( 2008-03-01), p. e687-e692
    Abstract: BACKGROUND. The measles-mumps-rubella vaccine has been associated with immune thrombocytopenia purpura in 2 small studies. METHODS. By using the Vaccine Safety Datalink, we identified measles-mumps-rubella–vaccinated children aged 1 to 18. A case of immune thrombocytopenia purpura was defined as a patient with a platelet count of ≤50000/μL with clinical bleeding and normal red and white blood cell indices. The immune thrombocytopenia purpura incidence rates during exposed (42 days after vaccination) and unexposed time periods were determined. A retrospective cohort of vaccinated children was used to determine incident rate ratios for children aged 1 to 18 years, 12 to 23 months, and 12 to 15 months. RESULTS. A total of 1036689 children received 1107814 measles-mumps-rubella vaccinations; there were 259 confirmed patients with immune thrombocytopenia purpura. Because only 5 exposed cases occurred after age 2, analyses were limited to children aged 12 to 23 months. Exposed patients aged 12 to 23 months had lower median platelet counts than those who were unexposed and had similar median duration of illness (11 vs 10 days). The incident rate ratio was highest for children aged 12 to 15 months at 7.10. The incident rate ratio for boys aged 12 to 15 months was 14.59, and the incident rate ratio for girls in the same age group was 3.22. Seventy-six percent of immune thrombocytopenia purpura cases in children aged 12 to 23 months were attributable to measles-mumps-rubella vaccination. This vaccine causes 1 case of immune thrombocytopenia purpura per every 40000 doses. CONCLUSION. Measles-mumps-rubella vaccine that is given in the second year of life is associated with an increased risk of immune thrombocytopenia purpura.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2007-1578
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2008
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  • 4
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    Online Resource
    Measles-Containing Vaccines and Febrile Seizures in Children Age 4 to 6 Years
    American Academy of Pediatrics (AAP) ; 2012
    In:  Pediatrics Vol. 129, No. 5 ( 2012-05-01), p. 809-814
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 129, No. 5 ( 2012-05-01), p. 809-814
    Abstract: In the United States, children receive 2 doses of measles-mumps-rubella vaccine (MMR) and varicella vaccine (V), the first between ages 1 to 2 years and the second between ages 4 to 6 years. Among 1- to 2-year-olds, the risk of febrile seizures 7 to 10 days after MMRV is double that after separate MMR + V. Whether MMRV or MMR + V affects risk for febrile seizure risk among 4- to 6-year-olds has not been reported. METHODS: Among 4- to 6-year-old Vaccine Safety Datalink members, we identified seizures in the emergency department and hospital from 2000 to 2008 and outpatient visits for fever from 2006 to 2008 during days 7 to 10 and 0 to 42 after MMRV and MMR + V. Incorporating medical record reviews, we assessed seizure risk after MMRV and MMR + V. RESULTS: From 2006 through 2008, 86 750 children received MMRV; from 2000 through 2008, 67 438 received same-day MMR + V. Seizures were rare throughout days 0 to 42 without peaking during days 7 to 10. There was 1 febrile seizure 7 to 10 days after MMRV and 0 after MMR + V. Febrile seizure risk was 1 per 86 750 MMRV doses (95% confidence interval, 1 per 3 426 441, 1 per 15 570) and 0 per 67 438 MMR + V doses (1 per 18 282). CONCLUSIONS: This study provides reassurance that MMRV and MMR + V were not associated with increased risk of febrile seizures among 4- to 6-year-olds. We can rule out with 95% confidence a risk greater than 1 febrile seizure per 15 500 MMRV doses and 1 per 18 000 MMR + V doses.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2011-3198
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2012
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  • 5
    Online Resource
    Online Resource
    Safety of Live-Attenuated Vaccines in Children Exposed to Biologic Response Modifiers in Utero
    American Academy of Pediatrics (AAP) ; 2022
    In:  Pediatrics Vol. 150, No. 1 ( 2022-07-01)
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 150, No. 1 ( 2022-07-01)
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2021-056021
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2022
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  • 6
    Online Resource
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    Injection Site and Risk of Medically Attended Local Reactions to Acellular Pertussis Vaccine
    American Academy of Pediatrics (AAP) ; 2011
    In:  Pediatrics Vol. 127, No. 3 ( 2011-03-01), p. e581-e587
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 127, No. 3 ( 2011-03-01), p. e581-e587
    Abstract: To assess whether the risk of medically attended local reactions to the fifth dose of the diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine varies according to injection site (arm versus thigh). METHODS: We conducted a retrospective cohort study of children aged 4 through 6 years in the Vaccine Safety Datalink population who received a DTaP vaccination during the period from 2002 through 2006. Medically attended local reactions to the DTaP vaccine were presumptively identified from administrative data and were confirmed by medical record review. RESULTS: Among the 233 616 children in the study population, 1017 (0.4%) had a confirmed medically attended local reaction to the fifth dose of the DTaP vaccine. The rate of those reactions was significantly higher with vaccinations given in the arm (47.4 per 10 000 vaccinations) compared with vaccinations given in the thigh (32.1 per 10 000 vaccinations) (P & lt; .001). In a multivariable analysis adjusted for age, gender, and study site, children vaccinated in the arm had a 78% higher risk of a local reaction (relative risk: 1.78 [95% confidence interval: 1.43–2.21]). CONCLUSIONS: Local reactions to the fifth dose of the DTaP vaccine that require medical evaluation are uncommon, but the risk of those reactions is significantly higher when the vaccine is injected in the arm. These findings suggest that the thigh should be considered as an acceptable site of injection for this vaccination.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2010-1886
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2011
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  • 7
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    Illnesses and Absence Due to Illness Among Children Attending Child Care Facilities in Seattle-King County, Washington
    American Academy of Pediatrics (AAP) ; 1997
    In:  Pediatrics Vol. 100, No. 5 ( 1997-11-01), p. 850-855
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 100, No. 5 ( 1997-11-01), p. 850-855
    Abstract: Objectives. Although much of the economic impact of child care-associated illness in the United States is due to parents' time lost from work, there are no data on the incidence of absence due to illness among children in various types of out-of-home child care settings in the United States. The goals of this study were to compare the incidence of illness and absence due to illness among children attending child care homes (CCHs) and child care centers (CCCs). Methods. From July 1992 through June 1993, child care providers from 91 CCHs and 41 CCCs in Seattle-King County, Washington, provided information on absenteeism and illness for 96 792 child-weeks of observation. Results. The age-adjusted incidence of provider-reported illness episodes among children in CCHs (10.4 episodes per 100 child-weeks) was greater than that among children in CCCs (6.7 episodes per 100 child-weeks). The incidence density ratio of illness among children & lt;1 year of age in comparison to those ≥5 years of age in CCCs (4.5) was greater than that among similar groups in CCHs (2.3). The age-adjusted incidence of absence due to illness among children in CCHs (5.1 days per 100 child-weeks) was less than that among children in CCCs (8.9 days per 100 child-weeks). Conclusions. Results comparing the incidence of illness between children in various types of child care settings may be influenced by information sources. The incidence of illness among children in CCHs may be greater than that among children in CCCs. The increased incidence of absence due to illness among children in CCCs compared with that among children in CCHs probably reflects differences in exclusion and attendance policies and practices between these two types of settings.
    Type of Medium: Online Resource
    ISSN: 1098-4275 , 0031-4005
    URL: Article
    DOI: 10.1542/peds.100.5.850
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 1997
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  • 8
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    Compliance With the Recommendations for 2 Doses of Trivalent Inactivated Influenza Vaccine in Children Less Than 9 Years of Age Receiving Influenza Vaccine for the First Time: A Vaccine Safety Datalink Study
    American Academy of Pediatrics (AAP) ; 2006
    In:  Pediatrics Vol. 118, No. 5 ( 2006-11-01), p. 2032-2037
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 118, No. 5 ( 2006-11-01), p. 2032-2037
    Abstract: OBJECTIVES. Children & lt;9 years of age do not respond optimally to a first dose of trivalent inactivated influenza vaccine, and so 2 doses of trivalent inactivated influenza vaccine are recommended for children & lt;9 years of age who are being vaccinated for the first time. We conducted a population-based retrospective cohort study to evaluate compliance with the 2-dose trivalent inactivated influenza vaccine recommendations. POPULATION AND SETTING. We evaluated 125928 children 6 months through 8 years of age who were enrolled in health maintenance organizations in the United States participating in the Vaccine Safety Datalink project and who received their first dose of trivalent inactivated influenza vaccine in the 2001–2002, 2002–2003, or 2003–2004 influenza seasons. RESULTS. Compliance with the 2 dose recommendations varied by age group and influenza season. Among children 6 to 23 months of age, the proportion of first-vaccinated children who received a second vaccination was 44% in 2001–2002, 54% in 2002–2003, and 29% in 2003–2004. Among children 2 to 8 years of age, the corresponding proportions were 15%, 24%, and 12%, respectively. In all seasons, compliance with the second vaccination was highest in children first vaccinated by mid-November. CONCLUSIONS. The majority of children who received their first dose of trivalent inactivated influenza vaccine did not complete the 2-dose series. The recently expanded recommendation for universal vaccination of children 6 to 59 months of age and their household contacts will substantially increase the number of children targeted for a first influenza vaccination. Noncompliance with the 2-dose trivalent inactivated influenza vaccine series may be associated with suboptimal protection against infection, which may impact the magnitude of the direct and indirect benefits achieved by the vaccination program.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2006-1422
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2006
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  • 9
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    Online Resource
    Vaccination Site and Risk of Local Reactions in Children 1 Through 6 Years of Age
    American Academy of Pediatrics (AAP) ; 2013
    In:  Pediatrics Vol. 131, No. 2 ( 2013-02-01), p. 283-289
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 131, No. 2 ( 2013-02-01), p. 283-289
    Abstract: Our objective was to assess whether the occurrence of medically attended local reactions to intramuscularly administered vaccines varies by injection site (arm versus thigh) in children 1 to 6 years of age. METHODS: This is a retrospective cohort study of children in the Vaccine Safety Datalink population from 2002 to 2009. Site of injection and the outcome of medically attended local reactions were identified from administrative data. RESULTS: The study cohort of 1.4 million children received 6.0 million intramuscular (IM) vaccines during the study period. The primary analyses evaluated the IM vaccines most commonly administered alone, which included inactivated influenza, hepatitis A, and diphtheria-tetanus-acellular pertussis (DTaP) vaccines. For inactivated influenza and hepatitis A vaccines, local reactions were relatively uncommon, and there was no difference in risk of these events with arm versus thigh injections. The rate of local reactions after DTaP vaccines was higher, and vaccination in the arm was associated with a significantly greater risk of this outcome compared with vaccination in the thigh, both for children 12 to 35 months (relative risk: 1.88 [95% confidence interval: 1.34–2.65]) and 3 to 6 years of age (relative risk: 1.41 [95% confidence interval: 0.84–2.34] ), although this difference was not statistically significant in the older age group. CONCLUSIONS: Injection in the thigh is associated with a significantly lower risk of a medically attended local reaction to a DTaP vaccination among children 12 to 35 months of age, supporting current recommendations to administer IM vaccinations in the thigh for children younger than 3 years of age.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2012-2617
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2013
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  • 10
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    Prophylaxis With Acetaminophen or Ibuprofen for Prevention of Local Reactions to the Fifth Diphtheria-Tetanus Toxoids-Acellular Pertussis Vaccination: A Randomized, Controlled Trial
    American Academy of Pediatrics (AAP) ; 2006
    In:  Pediatrics Vol. 117, No. 3 ( 2006-03-01), p. 620-625
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 117, No. 3 ( 2006-03-01), p. 620-625
    Abstract: BACKGROUND. The frequency of local vaccination reactions increases with successive doses of diphtheria-tetanus toxoids-acellular pertussis (DTaP) vaccine, and local reactions occur for the majority of children receiving the fifth DTaP vaccination. It is not known whether these reactions can be prevented with prophylactic use of acetaminophen or ibuprofen. METHODS. In this 3-group, randomized, blinded, controlled trial, 372 children were assigned randomly, in a 2:2:1 ratio, to receive 3 doses of acetaminophen, ibuprofen, or placebo. The first dose of study medication was administered within 2 hours before the fifth DTaP vaccination, and the remaining 2 doses were given at 6-hour intervals. The primary outcome measures included a local reaction with an area of redness or discoloration ≥5 cm in diameter on the evening of or during the 2 days after vaccination, an increase in mid-limb circumference of ≥2 cm on the evening of or during the 2 days after vaccination, and a persistent local reaction, defined as an area of redness or discoloration present on the third day after vaccination. RESULTS. Local reactions with a ≥5-cm area of redness or discoloration were reported for 35% of children in the placebo group, compared with 33% of children in the acetaminophen group and 37% of children in the ibuprofen group. There was also no significant difference between the placebo and treatment groups in the proportions of children with a ≥2-cm increase in mid-limb circumference or with a persistent local reaction. CONCLUSIONS. We did not find evidence that prophylaxis with acetaminophen or ibuprofen offers a clinically significant benefit in prevention of local reactions to the fifth DTaP vaccination.
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.2005-1217
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2006
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