Human papillomavirus vaccination and all-cause morbidity in adolescent girls: a cohort study of absence from school due to illness
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Human papillomavirus vaccination and all-cause morbidity in adolescent girls : a cohort study of absence from school due to illness. / Hviid, Anders; Thorsen, Nicklas M.; Thomsen, Louise N.; Møller, Frederik T.; Wiwe, Andreas; Frisch, Morten; Valentiner-Branth, Palle; Rytter, Dorte; Mølbak, Kåre.
I: International Journal of Epidemiology, Bind 50, Nr. 2, 2021, s. 518-526.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Human papillomavirus vaccination and all-cause morbidity in adolescent girls
T2 - a cohort study of absence from school due to illness
AU - Hviid, Anders
AU - Thorsen, Nicklas M.
AU - Thomsen, Louise N.
AU - Møller, Frederik T.
AU - Wiwe, Andreas
AU - Frisch, Morten
AU - Valentiner-Branth, Palle
AU - Rytter, Dorte
AU - Mølbak, Kåre
N1 - Publisher Copyright: © The Author(s) 2021. Published by Oxford University Press on behalf of the International Epidemiological Association.
PY - 2021
Y1 - 2021
N2 - BACKGROUND: A growing body of evidence supports the safety of the human papillomavirus (HPV) vaccines. However, concerns about autonomic dysfunction syndromes and non-specific symptoms continue to linger. These conditions are not easily captured by traditional diagnostic classification schemes and call for innovative approaches to the study of vaccine safety which take more general measures of all-cause morbidity into account. METHODS: Taking advantage of the unique Danish registers, including regional registration of absence from school, we conducted a cohort study of 14 068 adolescent Danish girls attending 5th through 9th grade in public schools in the municipality of Copenhagen during 1 August 2013-23 January 2018. We obtained time-varying HPV vaccination status and demographic information from nationwide registers. Using Poisson regression with random effects, we estimated rate ratios (RRs) of absence due to illness, comparing HPV-vaccinated girls with unvaccinated girls with adjustment for grade, season, calendar period, demographic factors and random effects at the individual, class and school levels. RESULTS: Our study included 6 206 188 school days with 213 221 days of absence from school due to illness (absence rate, 3.4%). Comparing absence rates due to illness in HPV-vaccinated and unvaccinated girls yielded an adjusted RR of 1.00 (95% confidence interval [CI], 0.98-1.03). CONCLUSIONS: Our study provides an important and novel contribution to HPV vaccine safety. Using absence from school records, we were able to address important safety concerns without relying on medical diagnoses. We conclude that HPV vaccination does not increase the risk of morbidity in any manner that manifests as absence from school due to illness.
AB - BACKGROUND: A growing body of evidence supports the safety of the human papillomavirus (HPV) vaccines. However, concerns about autonomic dysfunction syndromes and non-specific symptoms continue to linger. These conditions are not easily captured by traditional diagnostic classification schemes and call for innovative approaches to the study of vaccine safety which take more general measures of all-cause morbidity into account. METHODS: Taking advantage of the unique Danish registers, including regional registration of absence from school, we conducted a cohort study of 14 068 adolescent Danish girls attending 5th through 9th grade in public schools in the municipality of Copenhagen during 1 August 2013-23 January 2018. We obtained time-varying HPV vaccination status and demographic information from nationwide registers. Using Poisson regression with random effects, we estimated rate ratios (RRs) of absence due to illness, comparing HPV-vaccinated girls with unvaccinated girls with adjustment for grade, season, calendar period, demographic factors and random effects at the individual, class and school levels. RESULTS: Our study included 6 206 188 school days with 213 221 days of absence from school due to illness (absence rate, 3.4%). Comparing absence rates due to illness in HPV-vaccinated and unvaccinated girls yielded an adjusted RR of 1.00 (95% confidence interval [CI], 0.98-1.03). CONCLUSIONS: Our study provides an important and novel contribution to HPV vaccine safety. Using absence from school records, we were able to address important safety concerns without relying on medical diagnoses. We conclude that HPV vaccination does not increase the risk of morbidity in any manner that manifests as absence from school due to illness.
KW - all-cause morbidity
KW - HPV vaccination
KW - school absence
KW - vaccine safety
U2 - 10.1093/ije/dyab003
DO - 10.1093/ije/dyab003
M3 - Journal article
C2 - 33547468
AN - SCOPUS:85107083353
VL - 50
SP - 518
EP - 526
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
SN - 0300-5771
IS - 2
ER -
ID: 272116003