Timing of routine immunisations and subsequent hay fever risk
Open accessAbstract
BACKGROUND: Suggestions that immunisation influences allergic disease risk, either positively (pertussis) or negatively (BCG) are of concern for vaccination policy. AIMS: To determine whether DTP, MMR, and BCG vaccination in infancy influenced hay fever risk. METHODS: Case-control study of 7098 hay fever cases and controls, within two primary care databases. One control per case was matched for practice, age, and sex. Odds ratios (OR) were derived using conditional logistic regression. RESULTS: Compared to those completing in month 5 (base group) (39.3%), DTP unvaccinated children (4.3%) had a similar risk of hay fever (OR = 0.94, 95% CI 0.73 to 1.23). However, those completing after 12 months (4.2%) had a reduced risk (OR = 0.60, 95% CI 0.45 to 0.76) compared to the base group. Compared to those vaccinated in month 14 (base group) (29.5%), MMR unvaccinated children (2.3%) had an OR of 0.79 (95% CI 0.58 to 1.08). Completion of MMR after two years was associated with reduced hay fever risk (OR = 0.62, 95% CI 0.48 to 0.80) compared to the base group. The effects of late immunisation with DTP and MMR were independent. Those vaccinated with BCG by age 2 (2.4%) had an odds ratio of 1.28 (95% CI 0.96 to 1.70). Adjustment for consulting behaviour, social factors, or sibship size did not alter these associations. CONCLUSIONS: Immunisation against DTP or MMR does not increase the risk of hay fever. The lower confidence limit for BCG vaccination contradicts the hypothesised protective effect. The reduced risk of hay fever among children immunised late may be explained by a third factor causing both postponement and reduced risk such as intercurrent febrile illnesses.
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MMR unvaccinated children compared with vaccinated in month 14 (base group) had an OR of 0.79 (95% CI 0.78 to 1.08).
“MMR unvaccinated children compared with vaccinated in month 14 (base group) had an OR of 0.79 (95% CI 0.78 to 1.08).”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Bremner 2005
Table 3 (pooled results) reports an OR of 0.79 for children with no MMR vaccination, using vaccination in month 14 as the reference group. Its 95% CI is 0.58 to 1.08, not 0.78 to 1.08 as claimed. (LLM, conf=0.95)
Experimental — accuracy not yet measuredInfants who received MMR vaccination did not have a greater or lesser risk of developing hay fever than unvaccinated children.
“After performing a conditional logistic regression the authors reported that infants who received MMR vaccination did not have a greater or lesser risk of developing hay fever than unvaccinated children.”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Bremner 2005
A reduced risk of hay fever was noted after completing MMR after two years of age (OR 0.62; 95% CI 0.48 to 0.80).
“A reduced risk of hay fever was noted after completing MMR after two years of age (OR 0.62; 95% CI 0.48 to 0.80).”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Bremner 2005
In Black 2003, Bremner 2005, Bremner 2007, DeStefano 2004, Ma 2005, Mrozek-Budzyn 2010, Ray 2006, and Smeeth 2004, the risk of bias was moderate/unknown.
“Moderate/unknown risk of bias: eight studies (Black 2003; Bremner 2005; Bremner 2007; DeStefano 2004; Ma 2005; Mrozek-Budzyn 2010; Ray 2006; Smeeth 2004).”
From Vaccines for measles, mumps and rubella in children (2012) · cites this paper as Bremner 2005
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Self-citation
- Authors
- Bremner, S. A.
- Affiliations
- St George's Hospital (GB)
- Corresponding author
- Bremner, S A
- ORCID
- Bremner, S A
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2005-06-01
- Volume
- 90
- Issue
- 6
- Pages
- 567-573
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- PMC
- PMC1720414
- OpenAlex
- W2098540338
- Cited by
- 44
- References
- 43
- Citations by year
- 2025: 1 · 2023: 1 · 2021: 1 · 2020: 2 · 2019: 2 · 2018: 2 · 2017: 2 · 2015: 1 · 2013: 4 · 2012: 1
- FWCI
- 2.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Funders
- Wellcome Trust
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Immune responses and vaccinations
- Health Sciences › Medicine › Immunology and Allergy › Allergic Rhinitis and Sensitization
- Health Sciences › Medicine › Immunology and Allergy › Food Allergy and Anaphylaxis Research
- Keywords
- allergic rhinitis, DTP vaccine, MMR vaccine, BCG vaccine, vaccine safety, childhood allergy risk, febrile illness
- MeSH terms
- Age Factors, BCG Vaccine, Child, Preschool, Female, United Kingdom, Rhinitis, Allergic, Seasonal, Humans, Immunization Schedule, Infant, Male, Vaccination, Diphtheria-Tetanus-Pertussis Vaccine, Case-Control Studies, Risk Assessment, Measles-Mumps-Rubella Vaccine
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