Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination

The Accelerated Development of VAccine benefit-risk Collaboration in Europe (ADVANCE), a public-private consortium, implemented and tested a distributed network system for the generation of evidence on the benefits-risks of marketed vaccines in Europe. We tested the system by estimating the incidenc...

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Main Authors: Tin Tin Htar, M, De Ridder, M, Braeye, T, Correa, A, McGee, C, De Lusignan, S, Duarte-Salles, T, Huerta-Alvares, C, Martín-Merino, E, Tramontan, L, Danieli, G, Picelli, G, Van Der Maas, N, Berencsi, K, Arnheim-Dahlström, L, Heininger, U, Emborg, H, Weibel, D, Bollaerts, K, Sturkenboom, M
Format: Journal article
Language:English
Published: Elsevier 2019
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author Tin Tin Htar, M
De Ridder, M
Braeye, T
Correa, A
McGee, C
De Lusignan, S
Duarte-Salles, T
Huerta-Alvares, C
Martín-Merino, E
Tramontan, L
Danieli, G
Picelli, G
Van Der Maas, N
Berencsi, K
Arnheim-Dahlström, L
Heininger, U
Emborg, H
Weibel, D
Bollaerts, K
Sturkenboom, M
author_facet Tin Tin Htar, M
De Ridder, M
Braeye, T
Correa, A
McGee, C
De Lusignan, S
Duarte-Salles, T
Huerta-Alvares, C
Martín-Merino, E
Tramontan, L
Danieli, G
Picelli, G
Van Der Maas, N
Berencsi, K
Arnheim-Dahlström, L
Heininger, U
Emborg, H
Weibel, D
Bollaerts, K
Sturkenboom, M
author_sort Tin Tin Htar, M
collection OXFORD
description The Accelerated Development of VAccine benefit-risk Collaboration in Europe (ADVANCE), a public-private consortium, implemented and tested a distributed network system for the generation of evidence on the benefits-risks of marketed vaccines in Europe. We tested the system by estimating the incidence rate (IR) of pertussis and pertussis-related complications in children vaccinated with acellular (aP) and whole-cell (wP) pertussis vaccine. Data from seven electronic databases from four countries (Denmark: AUH and SSI, Spain: SIDIAP and BIFAP, UK: THIN and RCGP RSC and Italy: Pedianet) were included in a retrospective cohort analysis. Exposure was defined as any pertussis vaccination (aP or wP). The follow-up time started 14 days after the first dose. Children who had received any pertussis vaccine from January 1990 to December 2015 were included (those who switched type, or had unknown type were excluded). The outcomes of interest were confirmed or suspected pertussis and pertussis-related pneumonia and generalised convulsions within one month of pertussis diagnosis and death within three months of pertussis diagnosis. The cohort comprised 2,886,367 children ≤5 years of age. Data on wP and aP vaccination were available in three and seven databases, respectively. The IRs (per 100,000 person-years) for pertussis varied largely and ranged between 0.15 (95% CI: 0.12; 0.19) and 1.15 (95% CI: 1.07; 1.23), and the trends over time was consistent with those observed from national surveillance databases for confirmed pertussis. The pertussis IRs decreased as the number of wP and aP vaccine doses increased. Pertussis-related complications were rare (89 pneumonia, 7 generalised convulsions and no deaths) and their relative risk (vs. non-pertussis) could not be reliably estimated. The study demonstrated the feasibility of the ADVANCE system to estimate the change in pertussis IRs following pertussis vaccination. Larger sample sizes would provide additional power to compare the risk for complications between children with and without pertussis. The feasibility of vaccine-type specific effectiveness studies may be considered in the future.
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spelling oxford-uuid:8cd1735e-1ea8-4351-a1da-14bcb6c179632023-07-06T11:04:04ZAdvance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccinationJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:8cd1735e-1ea8-4351-a1da-14bcb6c17963EnglishSymplectic Elements at OxfordElsevier2019Tin Tin Htar, MDe Ridder, MBraeye, TCorrea, AMcGee, CDe Lusignan, SDuarte-Salles, THuerta-Alvares, CMartín-Merino, ETramontan, LDanieli, GPicelli, GVan Der Maas, NBerencsi, KArnheim-Dahlström, LHeininger, UEmborg, HWeibel, DBollaerts, KSturkenboom, MThe Accelerated Development of VAccine benefit-risk Collaboration in Europe (ADVANCE), a public-private consortium, implemented and tested a distributed network system for the generation of evidence on the benefits-risks of marketed vaccines in Europe. We tested the system by estimating the incidence rate (IR) of pertussis and pertussis-related complications in children vaccinated with acellular (aP) and whole-cell (wP) pertussis vaccine. Data from seven electronic databases from four countries (Denmark: AUH and SSI, Spain: SIDIAP and BIFAP, UK: THIN and RCGP RSC and Italy: Pedianet) were included in a retrospective cohort analysis. Exposure was defined as any pertussis vaccination (aP or wP). The follow-up time started 14 days after the first dose. Children who had received any pertussis vaccine from January 1990 to December 2015 were included (those who switched type, or had unknown type were excluded). The outcomes of interest were confirmed or suspected pertussis and pertussis-related pneumonia and generalised convulsions within one month of pertussis diagnosis and death within three months of pertussis diagnosis. The cohort comprised 2,886,367 children ≤5 years of age. Data on wP and aP vaccination were available in three and seven databases, respectively. The IRs (per 100,000 person-years) for pertussis varied largely and ranged between 0.15 (95% CI: 0.12; 0.19) and 1.15 (95% CI: 1.07; 1.23), and the trends over time was consistent with those observed from national surveillance databases for confirmed pertussis. The pertussis IRs decreased as the number of wP and aP vaccine doses increased. Pertussis-related complications were rare (89 pneumonia, 7 generalised convulsions and no deaths) and their relative risk (vs. non-pertussis) could not be reliably estimated. The study demonstrated the feasibility of the ADVANCE system to estimate the change in pertussis IRs following pertussis vaccination. Larger sample sizes would provide additional power to compare the risk for complications between children with and without pertussis. The feasibility of vaccine-type specific effectiveness studies may be considered in the future.
spellingShingle Tin Tin Htar, M
De Ridder, M
Braeye, T
Correa, A
McGee, C
De Lusignan, S
Duarte-Salles, T
Huerta-Alvares, C
Martín-Merino, E
Tramontan, L
Danieli, G
Picelli, G
Van Der Maas, N
Berencsi, K
Arnheim-Dahlström, L
Heininger, U
Emborg, H
Weibel, D
Bollaerts, K
Sturkenboom, M
Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination
title Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination
title_full Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination
title_fullStr Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination
title_full_unstemmed Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination
title_short Advance system testing: Vaccine benefit studies using multi-country electronic health data: the example of pertussis vaccination
title_sort advance system testing vaccine benefit studies using multi country electronic health data the example of pertussis vaccination
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