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The UK accelerated immunisation programme and sudden unexpected death in infancy: case-control study

Lookup NU author(s): Dr Martin Ward Platt



Objectives To investigate whether the accelerated immunisation programme in the United Kingdom is associated after adjustment for potential confounding, with the sudden infant death syndrome. Design Population based case-control study; February 1993 to March 1996. Parental interviews were conducted for each death and for four controls matched fur age, locality; and time of sleep, Immunisation status was taken from records held by the parents. Setting Five regions in England with a combined population of over 17 million, Subjects Immunisation details were available for 93% (303/325) of infants whose deaths were attributed to the sudden infant death syndrome (SIDS): 90% (65/72) of infants with explained sudden deaths; and 95%, (1515//1588) of controls. Results After alt potential confounding factors were controlled for, immunisation uptake was strongly associated with a lower risk of SIDS (odds ratio 0.45 (95% confidence interval 0.24 to 0.85), This difference became non-significant (0.67; (0.31 to 1.43)) after further adjustment for other factors specific to the infant's sleeping environment. Similar proportions of SIDS deaths and reference sleeps (corresponding to the time of day during which the index baby had died) among the controls occurred within 48 hours of the last vaccination (5% (7/149) v 5% (41/822)) and within two weeks (21% (31/149) v 27% (224/822)). No longer term temporal association with immunisation was found (P = 0.78). Of the SIDS infants who died within two weeks of vaccination, 16% (5/31) had signs and symptoms of illness that suggested that medical contact was required, compared with 26% (16/61) of the non-immunised SIDS infants of similar age. The findings for the infants who died suddenly and unexpectedly but of explained causes mirrored those for SIDS infants. Conclusions Immunisation does not lead to sudden unexpected death in infancy, and the direction of the relation is towards protection rather than risk.

Publication metadata

Author(s): Fleming PJ, Blair PS, Ward Platt MP, Tripp J, Smith IJ, Golding J

Publication type: Article

Publication status: Published

Journal: British Medical Journal

Year: 2001

Volume: 322

Issue: 7290

Pages: 822-825

Date deposited: 16/11/2010

ISSN (print): 0959-8138

ISSN (electronic): 1756-1833

Publisher: BMJ Group


DOI: 10.1136/bmj.322.7290.822


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