1686. Multiple Vaccine Antigen Exposure and Risk of Nontargeted Infections in Young Children
Session: Oral Abstract Session: Vaccines in the Young and Vulnerable
Friday, October 28, 2016: 2:15 PM
Room: 388-390
Background: Between 1983 and 2015, the routine childhood immunization schedule grew from 3 vaccines against 7 diseases to 10 vaccines against 14 diseases. This increase in vaccine exposure has led to concerns that early immunization “overloads the immune system”. It has been hypothesized that multiple antigen exposure from vaccines induces immune dysfunction and increases risk for infectious diseases not targeted by vaccines (i.e., nontargeted infections). An Institute of Medicine report concluded there was biological evidence that aggregated vaccine exposure could potentially lead to nontargeted infections. We conducted an epidemiological study to examine the association between multiple vaccine antigen exposure and risk of nontargeted infection in children.

Methods: This study setting was Kaiser Permanente Colorado, a Vaccine Safety Datalink site. In a cohort of children born 2004-2013, electronic vaccination records were linked with antigen amount. Exposure to vaccine antigens in the first 23 months of life was measured in two ways: cumulative antigen exposure and maximum antigen exposure per vaccine visit. Nontargeted infectious disease outcomes in ages 24-48 months were identified in emergency department and inpatient settings. The cohort was stratified by fully vaccinated children and children not vaccinated on time. Associations between vaccine antigen exposure and nontargeted infectious diseases were examined with Cox hazards models, adjusting for sex, chronic conditions and preterm birth.

Results: In a cohort of 22,278 children, 60% were fully vaccinated on time. Median cumulative antigen exposure was 277 (range: 191-343) for fully vaccinated children and 253 (range: 0-388) for children not vaccinated on time. Median maximum antigen exposure per visit was 107 (range: 69-141) for fully vaccinated children and 107 (range: 0-154) for children not vaccinated on time. Neither cumulative antigen exposure nor maximum antigen exposure per visit was associated with nontargeted infection (hazard ratio [HR]=0.99, 95% confidence interval [CI]=0.99-1.01; HR=1.01, 95% CI=0.98-1.03).

Conclusion: Antigen exposure from the current recommended childhood immunization schedule does not appear to increase risk for nontargeted infections.

Jason Glanz, PhD1,2, Sophia Newcomer, MPH1 and Matthew F. Daley, MD1, (1)Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, (2)Epidemiology, Colorado School of Public Health, Aurora, CO

Disclosures:

J. Glanz, None

S. Newcomer, None

M. F. Daley, None

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