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首页> 外文期刊>Vaccine >Factors that may explain observed associations between trivalent influenza vaccination and gastrointestinal illness in young children
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Factors that may explain observed associations between trivalent influenza vaccination and gastrointestinal illness in young children

机译：可能解释了三价流感疫苗接种与幼儿胃肠道疾病之间相关性的因素

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Background: Previously published studies reported an increased risk of gastrointestinal illness in the 14 days following trivalent influenza vaccination (TIV) in young children. While gastrointestinal illness may be a true adverse effect of TIV, other factors may influence this observed association, such as seasonal illness patterns and children being exposed to gastrointestinal pathogens at medical visits. The objective of this study was to examine factors influencing the association between TIV and gastrointestinal illness. Specifically, using data from a previous influenza vaccine safety study, we examined the association between medical encounters without TIV and gastrointestinal illness. Methods: Using electronic health record (EHR) data from 6 managed care organizations (MCOs), we identified medically attended gastrointestinal illness cases among children 24-59 months in the 2002-2006 influenza seasons. We matched each case to four controls on sex, birthdate (month/year), MCO, influenza season, and presence of a chronic condition. We then looked 1-14 days prior to the index date (gastrointestinal illness diagnosis date) to determine whether the child had a medical encounter. We excluded previous medical encounters with gastrointestinal-related diagnoses or TIV. Conditional logistic regression was used to calculate odds ratios and 95% confidence intervals. Results: We identified 2062 gastrointestinal illness cases and matched them to 8248 controls. We observed increased odds of gastrointestinal illness within 14 days after a medical encounter (odds ratio = 1.9; 95% confidence interval [CI]: 1.7-2.2) among children without chronic conditions. Among children with chronic conditions, the odds ratio was 3.9 (95% CI: 2.5-6.2). Conclusions: We demonstrated that another exposure related to vaccination, medical visits, is also associated with increased odds for gastrointestinal illness. This study highlights challenges of interpreting results from observational vaccine safety studies when there are co-occurring exposures, and the importance of investigating confounding in EHR data, which are an essential resource for vaccine safety research
机译：背景：先前发表的研究报告说，三价流感疫苗（TIV）接种后的14天内，胃肠道疾病的风险增加。尽管胃肠道疾病可能是TIV的真正不利影响，但其他因素也可能影响这种观察到的关联，例如季节性疾病模式和儿童在就诊时暴露于胃肠道病原体。这项研究的目的是检查影响TIV和胃肠道疾病之间关联的因素。具体而言，我们使用之前的流感疫苗安全性研究数据，研究了没有TIV的医学遭遇与胃肠道疾病之间的关联。方法：使用来自6个管理照护组织（MCO）的电子健康记录（EHR）数据，我们在2002-2006流感季节的24-59个月儿童中确定了医学治疗的胃肠疾病。我们将每个病例与性别，出生日期（月/年），MCO，流感季节和慢性病存在的四个对照相匹配。然后，我们在索引日期（胃肠道疾病诊断日期）之前的1-14天进行了检查，以确定孩子是否有过医疗经历。我们排除了先前与胃肠道相关的诊断或TIV的医疗经历。条件对数回归用于计算比值比和95％置信区间。结果：我们确定了2062例胃肠道疾病病例，并将其与8248例对照进行匹配。我们观察到没有慢性病的儿童在医疗遭遇后的14天内出现胃肠道疾病的几率增加（赔率= 1.9; 95％置信区间[CI]：1.7-2.2）。在患有慢性疾病的儿童中，优势比为3.9（95％CI：2.5-6.2）。结论：我们证明了另一种与疫苗接种有关的暴露，即就诊，也与胃肠道疾病几率增加有关。这项研究突出了在同时暴露的情况下解释性观察性疫苗安全性研究结果的挑战，以及调查EHR数据中混杂因素的重要性，这是疫苗安全性研究的重要资源

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