To date, there have been few comparative studies evaluating the safety of different vaccine schedules. A few of the existing studies show that there are cases in which the risk of adverse events depends on the vaccination schedule used. Hence, it is both a feasible and important area of study. As a relatively new field of investigatio, the big question is what types of study designs will be most appropriate for evaluating different childhood vaccine schedules. In this project, we will develop, evaluate, compare and illustrate a wide variety of new epidemiological methods for studying the safety of childhood vaccination schedules, with respect to a wide variety of different aspects and components of the vaccine schedule. These include the timing of individual vaccines; the timing between doses of the same vaccine; the interaction effect between vaccines and concurrent health conditions or pharmaceutical medications; the interaction effects of different vaccines given on the same day; the ordering of different vaccines; and the effect of cumulative summary metrics such as the total number of vaccines or the total amount of some vaccine ingredient. The project also covers study designs for the comparative evaluation of the CDC recommended schedule, popular alternative schedules and completely unvaccinated children. Methods will be developed for both adverse events with an early onset, which are the easiest to study, and for adverse events with a late onset, including serious chronic conditions.

Public Health Relevance

Vaccination is important for individual and public health. Post-market vaccine safety evaluations are done both in order to detect and minimize vaccine adverse events, when adverse events do exist, and in order to ensure the public that the vaccines are safe, when adverse events do not exist. New epidemiological methods are needed to study the safety of different aspects of the vaccination schedule.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI107721-04
Application #
9327862
Study Section
Infectious Diseases, Reproductive Health, Asthma and Pulmonary Conditions Study Section (IRAP)
Program Officer
Gezmu, Misrak
Project Start
2015-08-01
Project End
2019-07-31
Budget Start
2017-08-01
Budget End
2019-07-31
Support Year
4
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Brigham and Women's Hospital
Department
Type
DUNS #
030811269
City
Boston
State
MA
Country
United States
Zip Code
02115
Newcomer, Sophia R; Kulldorff, Martin; Xu, Stan et al. (2018) Bias from outcome misclassification in immunization schedule safety research. Pharmacoepidemiol Drug Saf 27:221-228
Wang, Shirley V; Abdurrob, Abdurrahman; Spoendlin, Julia et al. (2018) Methods for addressing ""innocent bystanders"" when evaluating safety of concomitant vaccines. Pharmacoepidemiol Drug Saf 27:405-412
Aloe, Carlin; Kulldorff, Martin; Bloom, Barry R (2017) Geospatial analysis of nonmedical vaccine exemptions and pertussis outbreaks in the United States. Proc Natl Acad Sci U S A 114:7101-7105
Toh, Sengwee; Gagne, Joshua J; Rassen, Jeremy A et al. (2013) Confounding adjustment in comparative effectiveness research conducted within distributed research networks. Med Care 51:S4-10
Greene, Sharon K; Rett, Melisa; Weintraub, Eric S et al. (2012) Risk of confirmed Guillain-Barre syndrome following receipt of monovalent inactivated influenza A (H1N1) and seasonal influenza vaccines in the Vaccine Safety Datalink Project, 2009-2010. Am J Epidemiol 175:1100-9
Gee, Julianne; Naleway, Allison; Shui, Irene et al. (2011) Monitoring the safety of quadrivalent human papillomavirus vaccine: findings from the Vaccine Safety Datalink. Vaccine 29:8279-84
Lee, Grace M; Greene, Sharon K; Weintraub, Eric S et al. (2011) H1N1 and seasonal influenza vaccine safety in the vaccine safety datalink project. Am J Prev Med 41:121-8