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Am J Epidemiol 2003; 157:158-165.
Copyright © 2003 by Johns Hopkins Bloomberg School of Public Health

ORIGINAL CONTRIBUTIONS

Risk Analysis of Aseptic Meningitis after Measles-Mumps-Rubella Vaccination in Korean Children by Using a Case-Crossover Design

Moran Ki1,, Taesung Park2, Sung Gon Yi2, Jin Kyoung Oh3 and BoYoul Choi3

1 Department of Preventive Medicine, Eulji University School of Medicine, Daejon, Korea.
2 Department of Statistics, Seoul National University, Seoul, Korea.
3 Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Korea.

Epidemiologic study of a vaccine’s adverse events is not easy; so many countries have no reliable data. Vaccines containing the Urabe or Hoshino strain have been withdrawn from use in several countries. However, the data are not strong enough to form the basis of a recommendation not to use specific strains. The authors used a case-crossover design to estimate the relative risk of aseptic meningitis in children after receiving the measles-mumps-rubella vaccine in Korea. Study subjects were hospitalized children aged 8–36 months who had aseptic meningitis in 1998. Cases were confirmed by hospital chart reviews using previously defined criteria. Through a telephone survey, the authors obtained vaccination date and place information from parents’ vaccination records. Study results showed that no significant risk was associated with the Jeryl Lynn or Rubini strain of the vaccine (relative risk = 0.6, 95% confidence interval (CI): 0.18, 1.97). For the Urabe or Hoshino strain, the relative risk was 5.5 (95% CI: 2.6, 11.8); the risk increased in the third week after vaccination (relative risk = 15.6, 95% CI: 5.9, 41.2) and was elevated until the sixth week. The case-crossover design was useful in confirming the risk of acute adverse events after receiving vaccines.

child, hospitalized; epidemiologic research design; infant; meningitis, aseptic; mumps vaccine; vaccines

Abbreviations: Abbreviations: CI, confidence interval; MMR, measles-mumps-rubella; RR, relative risk.


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