| Titre : | Underestimating the Safety Benefits of a New Vaccine : The Impact of Acellular Pertussis Vaccine Versus Whole-Cell Pertussis Vaccine on Health Services Utilization. (2012) |
| Auteurs : | Steven HAWKEN ; Natasha-S CROWCROFT ; Shelley-L DEEKS ; Jeffrey-C KWONG ; Douglas-G MANUEL ; Kumanan WILSON ; (I.C.E.S.@.U.O.T.T.A.W.A.). Ottawa Hospital Research Institute. University of Ottawa. Ottawa. ON. CAN ; Department of Clinical Epidemiology. Ottawa Hospital Research Institute. Ottawa. ON. CAN |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 176, n° 11, 2012) |
| Pagination : | 1035-1042 |
| Langues: | Anglais |
| Mots-clés : | Coqueluche ; Efficacité ; Sécurité ; Structure préventive ; Prévention santé ; Etude comparée ; Cellule ; Utilisation service ; Utilisation ; Accident médicamenteux ; Médicament ; Vaccin antidiphtérique ; Vaccination ; Diphtérie ; Vaccin antitétanique ; Tétanos ; Epidémiologie ; Surveillance ; Bactériose ; Infection |
| Résumé : | [BDSP. Notice produite par INIST-CNRS qF9R0xBk. Diffusion soumise à autorisation]. The population-level safety benefits of the acellular pertussis vaccine may have been underestimated because only specific adverse events were considered, not overall impact on health services utilization. Using the Vaccine and Immunization Surveillance in Ontario (VISION) system, the authors analyzed data on 567,378 children born between April 1994 and March 1996 (before introduction of acellular pertussis vaccine) and between April 1998 and March 2000 (after introduction of acellular pertussis vaccine) in Ontario, Canada. Using the self-controlled case series study design, they examined emergency room visits and hospital admissions occurring after routine pediatric vaccinations. The authors determined the relative incidence of events taking place before introduction of the acellular vaccine versus after introduction by calculating relative incidence ratios (RIRs). The observed RIRs demonstrated a highly statistically significant reduction in relative incidence after introduction of the acellular vaccine. RIRs for vaccine administered at ages 2,4,6, and 18 months were 1.82 (95% confidence interval (CI) : 1.64,2.01), 1.91 (95% CI : 1.71,2.13), 1.54 (95% CI : 1.38,1.72), and 1.51 (95% CI : 1.34,1.69), respectively, comparing event rates before the introduction of acellular vaccine with those after introduction. The authors estimated that approximately 90 emergency room visits and 9 admissions per month were avoided by switching to the acellular vaccine, which is a 38-fold higher impact than when they considered only admissions for febrile and afebrile convulsions. Future analyses comparing vaccines for safety should examine specific endpoints and general health services utilization. |
Service Documentation EHESP
Me connecter
PORTAIL DOCUMENTAIRE
École des hautes études en santé publique
Catalogue
Multi-bases
Accueil
Sélection de la langue
Adresse
Service Documentation EHESPBibliothèque Rennes Avenue du Professeur Léon Bernard – CS 74312 – 35043 Rennes Cedex Bibliothèque MSSH Paris 20 avenue George Sand - 93210 La Plaine Saint-Denis
France
Bibliothèque Rennes : 02 99 02 29 50 Bibliothèque MSSH Paris : 02 99 02 24 50
contact