Risk of hospitalization because of aseptic meningitis after measles-mumps-rubella vaccination in one- to two-year-old children: an analysis of the Vaccine Safety Datalink (VSD) Project
Abstract
OBJECTIVE: To assess the level of increased risk, if any, of hospitalizations for aseptic meningitis after Jeryl-Lynn mumps strain measles-mumps-rubella (MMR) vaccine in the Vaccine Safety Datalink population. STUDY DESIGN: A possible increased risk of aseptic meningitis 8 to 14 days after receipt of MMR was observed in a preliminary screening analysis of automated data from the Vaccine Safety Datalink (VSD) project Year 2 analysis. To further evaluate this association a retrospective 10-year matched case-control study was undertaken in the four health maintenance organizations (HMOs) in the VSD project. Cases ascertained from a broad scan of the automated data were validated against a standard case definition. Two controls matched on age, sex, HMO and HMO membership were assigned per case. RESULTS: The VSD project involves the cooperative collection of automated vaccination and medical outcome data from four large HMOs that currently have 500,000 children younger than 7 years of age under surveillance. Review of automated screening results from the first 2 years of data revealed a possible increased risk of aseptic meningitis 0 to 14 days after MMR with a relative risk of 3.61 (95% confidence interval, 1.0 to 13.1) although the total number of cases was small. Although the automated data had suggested a possible association of aseptic meningitis with MMR containing the Jeryl-Lynn strain of mumps, review of validated hospitalized cases during the observation period did not reveal evidence of an increased risk of aseptic meningitis after MMR containing the Jeryl-Lynn strain of mumps (odds ratio < 1.0 for all analyses). CONCLUSION: Although it is recognized that hospitalized cases represent a minority of the total cases of aseptic meningitis, it is reassuring that in this evaluation no increased risk of aseptic meningitis after MMR vaccine was found.
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In Black 1997, exposure to MMR vaccine was not statistically different between cases and controls for aseptic meningitis in any of the considered time intervals (0 to 14 days, 0 to 30 days, 8 to 14 days).
“Exposure to the MMR vaccine was not statistically different between cases and controls in any of the considered time intervals.”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Black 1997
In Black 1997 there was a moderate likelihood of selection bias because of missing cases and their records (up to 27%).
“In Black 1997 there was a moderate likelihood of selection bias because of missing cases and their records (up to 27%) but the study and its methods were well reported.”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Black 1997
In Black 1997 and Davis 2001, the risk of bias was low.
“Low risk of bias: two studies (Black 1997; Davis 2001).”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Black 1997
Cites
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Risk of aseptic meningitis after measles, mumps,and rubella vaccine in UK children
Miller, E., Farrington, P., Goldracre, M., Pugh, S., Colville, A., Flower, A. J. E., Nash, J., Macfarlane, L., & Tettmar, R. E. (1993) · The Lancet · doi:10.1016/0140-6736(93)91069-x · Cited by 203 · see citing works
Aseptic meningitis as a complication of mumps vaccination
Sugiura, A., & Yamada, A. (1991) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199103000-00008 · Cited by 127 · see citing works
A prefecture-wide survey of mumps meningitis associated with measles, mumps and rubella vaccine
Fujinaga, T., Motegi, Y., Tamura, H., & Kuroume, T. (1991) · The Pediatric Infectious Disease Journal · doi:10.1097/00006454-199103000-00007 · Cited by 64 · see citing works
Mumps meningitis and measles, mumps, and rubella vaccine
Colville, A., & Pugh, S. (1992) · The Lancet · doi:10.1016/0140-6736(92)92322-7 · Cited by 47 · see citing works
Wassilak, S. G. F., Glasser, J. W., Chen, R. T., Hadler, S. C., & THE VACCINE SAFETY DAIALINK INVESTIGATORS (1995) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1995.tb44473.x · Cited by 41 · see citing works
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Vaccines for measles, mumps and rubella in children
Demicheli, V., Rivetti, A., Debalini, M. G., & Di Pietrantonj, C. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004407.pub3 · Cited by 372 · see citing works
Neurologic disorders after measles-mumps-rubella vaccination
Mäkelä, A., Nuorti, J. P., & Peltola, H. (2002) · PEDIATRICS · doi:10.1542/peds.110.5.957 · Cited by 183 · see citing works
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- Authors
- BLACK, S., SHINEFIELD, H., RAY, P., LEWIS, E., CHEN, R., GLASSER, J., HADLER, S., HARDY, J., RHODES, P., SWINT, E., DAVIS, R., THOMPSON, R., MULLOOLY, J., MARCY, M., VADHEIM, C., WARD, J., RASTOGI, S., & WISE, R.
- Affiliations
- Group Health Cooperative (US)
- Venue
- The Pediatric Infectious Disease Journal
- Published
- 1997-05
- Volume
- 16
- Issue
- 5
- Pages
- 500-503
- ISSN
- 0891-3668 (ISSN-L)
- OpenAlex
- W1999970131
- Cited by
- 73
- References
- 6
- Citations by year
- 2026: 1 · 2025: 3 · 2023: 2 · 2022: 1 · 2021: 3 · 2020: 3 · 2018: 1 · 2017: 4 · 2016: 2 · 2015: 3 · 2013: 4 · 2012: 2
- FWCI
- 5.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Pediatric Infectious Disease Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Keywords
- aseptic meningitis, MMR vaccine, vaccine safety, hospitalization risk, infants and toddlers, vaccine adverse events
- MeSH terms
- Child, Preschool, Female, Health Maintenance Organizations, Hospitalization, Humans, Infant, Male, Measles Vaccine, Meningitis, Aseptic, Mumps Vaccine, Registries, Retrospective Studies, Risk Factors, Rubella Vaccine, Statistics as Topic, United States, Incidence, Confidence Intervals, Case-Control Studies, Vaccines, Combined, Measles-Mumps-Rubella Vaccine
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