187. Evaluation of Immunization Rates and Safety Among Children with Inborn Errors of Metabolism
Session: Oral Abstract Session: Pediatric and Adult Vaccines
Friday, October 30, 2009: 12:00 AM
Room: 109-AB
Background: Children with metabolic disorders are a potential high-risk group for vaccine-preventable diseases. Despite recommendations that they receive all routine immunizations, information regarding both immunization rates and safety data within this population is lacking.
Methods: Using Northern California Kaiser Permanente’s (NCKP) integrated electronic medical record, we identified children up to age 18 years who had an inborn error of metabolism (IEM) from 1990 to 2007. We assessed immunization rates among a subset of infants with IEM born at NCKP who were members until age 3 years matched to healthy infants (1:20), comparing both immunizations received by age 2 years and timing for receipt of vaccines. We next separately assessed for adverse events after immunization by using self-controlled analyses among all children up to age 18 years with an IEM who received at least 1 vaccine at any time, comparing emergency room visits and hospitalizations during post-vaccine days 0-30 to post-vaccine days 31-60.
Results: We identified 79 infants with IEM who were born and remained a member of NCKP at age 3 years. Compared to 1580 matched controls, there was no difference in the proportion of children with IEM up to date for vaccines at 2 years, nor was there any delayed receipt of recommended vaccines during the first year. We also preliminarily identified 322 children with IEM who received any vaccine. Preliminary analysis in this group did not detect an increase in emergency room visits [rate ratio (RR) 0.83, 95% confidence interval (CI) 0.60, 1.14] or hospitalizations (RR 1.1, 95% CI 0.9, 1.4) during the 30 days after vaccination compared to post-vaccine days 31-60.
Conclusion: Children with metabolic diseases in this cohort were vaccinated at rates comparable to healthy children. Although sample size is a limitation, preliminary evidence does not suggest an association between vaccination and an increased risk for serious adverse events.
Laurie Aukes, RN1, Roger Baxter, MD, Bruce Fireman, MA1, Nicola Klein, MD, PhD1, Janelle Lee, PhD1, Stuart Shapira, MD, PhD3, Marhall Summar, MD4 and  N. P. Klein,
GlaxoSmithKline Role(s): Research Relationship, Received: Research Support.
Sanofi Pasteur Role(s): Research Relationship, Received: Research Support.
Merck & Co Role(s): Research Relationship, Received: Research Support.
Novartis Role(s): Research Relationship, Received: Research Support.
L. Aukes, None..
J. Lee, None..
B. Fireman, None. 
R. Baxter,
GlaxoSmithKline Role(s): Research Relationship, Received: Research Support.
Merck & Co Role(s): Research Relationship, Received: Research Support.
Novartis Role(s): Research Relationship, Received: Research Support.
MedImmune Role(s): Research Relationship, Received: Research Support.
Sanofi Pasteur Role(s): Research Relationship, Received: Research Support.
S. K. Shapira, None..
M. L. Summar, None., (1)Kaiser Permanente Vaccine Study Center, Oakland, CA, (2)Center for Disease Control and Prevention, Atlanta, GA, (3)Vanderbilt University Medical Center, Nashville, TN