Abstract | BACKGROUND: Associations between vaccinations, particularly hepatitis B, and onset of rheumatoid arthritis (RA) have been reported, but examined in few large-scale studies. METHOD: Onset of RA cases and dates of vaccination against hepatitis B, tetanus, and influenza were identified in a retrospective chart review of approximately 1 million Kaiser Permanente Northern California members ages 15-59 years from 1997 through 1999. In a cohort analysis, rates of new-onset RA were compared between vaccinated and unvaccinated within 90, 180, and 365 days. In a case-control analysis, rates of vaccination during exposure intervals (90, 180, 365, and 730 days) were compared between cases and controls using conditional logistic regression. RESULTS: 378 RA cases were included in the cohort analysis; 37 additional cases were included in the case-control analysis. In the cohort analysis the relative risks of RA onset within 90, 180, or 365 days of hepatitis B vaccination were not significant (R.R.=1.44, p=0.53; R.R.=1.67, p=0.22; R.R.=1.23, p=0.59 respectively). We found a possible association between RA and influenza vaccine in the previous 180 and 365 days in the cohort analysis (R.R=1.36, p=0.03; R.R.=1.34, p=0.01 respectively), but in the case-control analysis, cases were no more likely than controls to have received any of the three vaccines. CONCLUSIONS: In this large retrospective study we found no statistically significant association between exposure to hepatitis B vaccine and onset of RA. A possible association between RA and influenza vaccination in the cohort study was not borne out in the larger case-control analysis.
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Authors | Paula Ray, Steven Black, Henry Shinefield, Aileen Dillon, Diane Carpenter, Edwin Lewis, Pat Ross, Robert T Chen, Nicola P Klein, Roger Baxter, Vaccine Safety Datalink Team |
Journal | Vaccine
(Vaccine)
Vol. 29
Issue 38
Pg. 6592-7
(Sep 02 2011)
ISSN: 1873-2518 [Electronic] Netherlands |
PMID | 21763385
(Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
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Copyright | Copyright © 2011 Elsevier Ltd. All rights reserved. |
Chemical References |
- Hepatitis B Vaccines
- Influenza Vaccines
- Tetanus Toxoid
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Topics |
- Adolescent
- Adult
- Arthritis, Rheumatoid
(chemically induced, epidemiology)
- California
(epidemiology)
- Case-Control Studies
- Female
- Hepatitis B Vaccines
(administration & dosage, adverse effects)
- Humans
- Influenza Vaccines
(administration & dosage, adverse effects)
- Male
- Middle Aged
- Retrospective Studies
- Risk Assessment
- Tetanus Toxoid
(administration & dosage, adverse effects)
- Vaccination
(adverse effects)
- Young Adult
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