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APHA Scientific Session and Event Listing

Ran Balicer, MD, MPH¹, Itamar Grotto, MD, MPH¹, Daniel Mimouni, MD², and Marc Mimouni, MD³. (1) Epidemiology Department, Ben-Gurion University of the Negev, PO BOX 653, Beer-Sheva, 84105, Israel, Beer-Sheva, Israel, 972-3-6704198, rbalicer@netvision.net.il, (2) Department of Dermatology, Rabin Medical Center, 49100, Petach-Tikva, Israel, (3) Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petach-Tikva, Israel

Introduction: The possible link between immunization and atopic diseases has been under intense debate in the last decade, and has yet to be decided. Both inciting and protective effects of immunization were suggested, depending on the specific vaccine and target population. We set out to systematically review the available evidence on the association between whole-cell pertussis and BCG vaccination and the risk of asthma in childhood and adolescence. Methods: Relevant birth-cohort studies and randomized controlled trials from 1966 to January 2006 were located. Inclusion criteria required comparison of vaccinated with non–vaccinated children, validation of vaccination status by medical records and pre-set criteria for asthma definition. Results were combined by applying a fixed-effect or random-effect model, according to studies heterogeneity. Sensitivity analyses according to scoring criteria were performed. Results: Seven studies relating to pertussis and five studies relating to BCG were included, accounting for 186,663 and 41,479 children, respectively. Overall odds ratio for asthma among vaccinated children were 0.99 (95% CI: 0.78-1.25) and 0.98 (95% CI: 0.88-1.08) for pertussis and BCG vaccines, respectively. This lack of significant association proved robust in sensitivity analyses for BCG, but choosing the 5 highest-scoring pertussis studies yielded a statistically significant association with pooled OR reaching 1.26 (95% CI=1.04-1.54). Conclusions: Currently available data do not support an association (inciting or protective) between administration of BCG or whole cell pertussis vaccines and risk of asthma in childhood and adolescence. This lack of significant association did not prove robust for pertussis vaccination, and further studies are needed.

Learning Objectives:

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• Describe the “hygiene theory” and its possible relevance to a potential association between vaccines and atopic diseases in childhood. •
• Recognize the available evidence on the association between childhood asthma and whole cell pertussis vaccination, BCG vaccination •
• Discuss the implications of the meta-analysis results for future vaccination campaigns and risk communication.

Keywords: Asthma, Immunizations

Presenting author's disclosure statement:

Not Answered