Assessing the Impact of Rotavirus Vaccination on Idiopathic Thrombocytopenic Purpura in the United States Open Access

Abstract

BACKGROUND

Rotavirus vaccination has been extremely effective in reducing rotavirus infections in the United States and has had several non-rotavirus impacts. Idiopathic/Immune Thrombocytopenic Purpura (ITP) is a blood disorder that has been linked with Measles Mumps Rubella vaccination in the past and its association with rotavirus vaccination are currently unknown.

METHODS

The MarketScan Commercial Claims and Encounters Database was utilized to perform a survival analysis on enrollees on the risk of developing ITP based on vaccination status while accounting for covariates such as sex of the enrollee and the enrollee’s geographic region. Of 371,422 enrollees from the 2009 MarketScan birth cohort, 292,566 enrollees were eligible for analysis.

RESULTS

Analysis of the data by vaccination status resulted in a hazard ratio of 1.10 with a 95% confidence interval of (95% CI: 0.48, 2.52). When controlling for sex, the hazard ratio was 1.07 (95% CI: 0.47, 2.46) and upon controlling for region, the hazard ratio was 1.10 (95% CI: 0.48, 2.52). The hazard ratios indicate little difference when controlling for the covariates.

CONCLUSION

We found no evidence of correlation between rotavirus vaccination and ITP. Additional studies might be required to more conclusively assess the effect of rotavirus vaccination on ITP.

Table of Contents

Table of Contents

ABSTRACT

BACKGROUND

METHODS

Data Source

Identification of ITP and Vaccination Status

Survival Analysis Data Setup

Calculation of Enrollee Age for Survival Analysis

Statistical Analysis

RESULTS

Vaccinated vs. Unvaccinated Enrollees

Enrollees with ITP vs. Enrollees without ITP

Survival analysis by Exposure: Vaccination Status and Potential Confounders: Sex and Region

Testing the Proportional Hazards (PH) Assumption

Log-Log Survival Curves

Goodness of Fit Testing

DISCUSSION

About this Master's Thesis

Rights statement

• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Rotavirus Vaccination
Committee Chair / Thesis Advisor	Benjamin Lopman, Emory University

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