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Association between Birth Order and Emergency Room Visits and Acute Hospital Admissions following Pediatric Vaccination: A Self-Controlled Study

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  • Steven Hawken
  • Jeffrey C Kwong
  • Shelley L Deeks
  • Natasha S Crowcroft
  • Robin Ducharme
  • Douglas G Manuel
  • Kumanan Wilson

Abstract

Objective: We investigated the association between a child's birth order and emergency room (ER) visits and hospital admissions following 2-,4-,6- and 12-month pediatric vaccinations. Methods: We included all children born in Ontario between April 1st, 2006 and March 31st, 2009 who received a qualifying vaccination. We identified vaccinations, ER visits and admissions using health administrative data housed at the Institute for Clinical Evaluative Sciences. We used the self-controlled case series design to compare the relative incidence (RI) of events among 1st-born and later-born children using relative incidence ratios (RIR). Results: For the 2-month vaccination, the RIR for 1st-borns versus later-born children was 1.37 (95% CI: 1.19–1.57), which translates to 112 additional events/100,000 vaccinated. For the 4-month vaccination, the RIR for 1st-borns vs. later-borns was 1.70 (95% CI: 1.45–1.99), representing 157 additional events/100,000 vaccinated. At 6 months, the RIR for 1st vs. later-borns was 1.27 (95% CI: 1.09–1.48), or 77 excess events/100,000 vaccinated. At the 12-month vaccination, the RIR was 1.11 (95% CI: 1.02–1.21), or 249 excess events/100,000 vaccinated. Conclusions: Birth order is associated with increased incidence of ER visits and hospitalizations following vaccination in infancy. 1st-born children had significantly higher relative incidence of events compared to later-born children.

Suggested Citation

  • Steven Hawken & Jeffrey C Kwong & Shelley L Deeks & Natasha S Crowcroft & Robin Ducharme & Douglas G Manuel & Kumanan Wilson, 2013. "Association between Birth Order and Emergency Room Visits and Acute Hospital Admissions following Pediatric Vaccination: A Self-Controlled Study," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-8, December.
    • Handle: RePEc:plo:pone00:0081070
    DOI: 10.1371/journal.pone.0081070
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    1. Kumanan Wilson & Steven Hawken & Jeffrey C Kwong & Shelley Deeks & Natasha S Crowcroft & Carl Van Walraven & Beth K Potter & Pranesh Chakraborty & Jennifer Keelan & Michael Pluscauskas & Doug Manuel, 2011. "Adverse Events following 12 and 18 Month Vaccinations: a Population-Based, Self-Controlled Case Series Analysis," PLOS ONE, Public Library of Science, vol. 6(12), pages 1-8, December.
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