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Vaccine. 2017 Mar 14;35(12):1615-1621. doi: 10.1016/j.vaccine.2017.02.013. Epub 2017 Feb 21.

Risk factors and familial clustering for fever 7-10days after the first dose of measles vaccines.

Author information

1
Kaiser Permanente Vaccine Study Center, Oakland, CA, United States. Electronic address: Nicola.Klein@kp.org.
2
Kaiser Permanente Vaccine Study Center, Oakland, CA, United States.
3
The Center for Health Research, Kaiser Permanente Northwest, Portland, OR, United States.
4
Kaiser Permanente Colorado, Denver Health, Denver, CO, United States.
5
Group Health Research Institute, Seattle, WA, United States.
6
Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Foundation, Marshfield, WI, United States.
7
Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States.
8
Immunization Safety Office, Centers for Disease Control and Prevention, Atlanta, GA, United States.

Abstract

BACKGROUND:

Seven to ten days after a first dose of a measles-containing vaccine (MCV; i.e., MMR or MMRV), children have elevated fever risk which can be associated with febrile seizures. This study investigated individual and familial factors associated with fever 7-10days after MCV.

METHODS:

Retrospective cohort study among children who were <36months of age at receipt of MCV in six sites of the Vaccine Safety Datalink from 1/1/2000 to 12/31/2012. We evaluated medically-attended clinic or emergency department visits with a code for fever 7-10days after any MCV ("MCV- associated"). We evaluated factors associated with MCV-associated fever using χ2 and multivariable logistic regression analyses.

RESULTS:

Among 946,806 children vaccinated with MCV, we identified 7480 (0.8%) MCV-associated fever visits. Compared with children without fever after MCV, children with MCV-associated fever were more likely to have received MMRV than MMR (OR 1.3 95% CI 1.2, 1.5), have had medically attended fever both following previous vaccines (OR 1.3 95% CI 1.1, 1.6) and at any other previous time (OR 1.7 95% CI 1.6, 1.8), have had at least 1 prior seizure (OR 2.2 95% CI 1.7, 2.7), and have had >3 medical visits within the 6months before MCV (OR 1.7 95% CI 1.6, 1.8). In families with multiple MCV-immunized children, after adjusting for healthcare seeking behavior care for fever, those whose siblings had MCV-associated fever were more likely to also have MCV-associated fever (OR 3.5 95% CI 2.5, 4.8).

DISCUSSION:

Children who received MMRV vaccine or who had prior medically-attended fevers and seizures during the first year of life had increased risk of fever after a first dose of measles vaccine. After adjusting for familial propensity to seek care, MCV-associated fever still clustered within families, suggesting a possible genetic basis for susceptibility to developing fever due to measles vaccines.

KEYWORDS:

Fever; Measles; Safety; Vaccine

PMID:
28233624
DOI:
10.1016/j.vaccine.2017.02.013
[Indexed for MEDLINE]

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