Asthma and risk of breakthrough varicella infection in children

Puja J Umaretiya; Jennifer B Swanson; Hyo-Jin Kwon; Charles Grose; Christine M Lohse; Young J Juhn

doi:10.2500/aap.2016.37.3951

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Asthma and risk of breakthrough varicella infection in children

Journal article

Open access

Peer reviewed

Asthma and risk of breakthrough varicella infection in children

Puja J Umaretiya, Jennifer B Swanson, Hyo-Jin Kwon, Charles Grose, Christine M Lohse and Young J Juhn

Allergy and asthma proceedings, Vol.37(3), pp.207-215

2016

DOI: 10.2500/aap.2016.37.3951

PMCID: PMC4846986

PMID: 27178889

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Abstract

Background: We recently reported a more rapid waning of vaccine-induced humoral immunity (measles vaccine) in children with asthma. It is unknown if asthma affects susceptibility to vaccine-preventable diseases. Objective: To determine whether asthma is associated with an increased risk of vaccine-preventable disease, e.g., breakthrough varicella infection. Methods: This was a retrospective population-based case-control study that examined cases of breakthrough varicella among children between 2005 and 2011. Children with a diagnosis of breakthrough varicella infection in Olmsted County, Minnesota (infection of >42 days after vaccination) between 2005 and 2011 and two age- and sex-matched controls were enrolled for each case. Asthma status was determined by using predetermined criteria. Conditional logistic regression models were used to calculate matched odds ratios (OR) and their corresponding 95% confidence intervals (CI). Results: Of the 165 cases and their 330 matched controls, 48% were boys and the mean (standard deviation) age at the index date was 6.6 ± 3.5 years for both cases and controls. Of the 330 controls, 80 (24%) had two doses of the varicella vaccine compared with only 23 (14%) of the 165 cases (OR 0.29 [95% CI, 0.14-0.61]; p = 0.001). Children with a history of asthma ever had a higher risk of developing breakthrough varicella compared with those without a history of asthma (adjusted OR 1.63 [95% CI, 1.04-2.55]; p = 0.032) when adjusting for elapsed time since the first varicella vaccination and the number of varicella vaccine doses. Conclusions: A history of asthma might be an unrecognized risk factor for breakthrough varicella infection. Children with asthma should follow the two-dose varicella vaccine policy.

Epidemiology

Asthma

humoral immunity

vaccine

children

waning

breakthrough infection

Varicella

immunity

Details

Title: Subtitle: Asthma and risk of breakthrough varicella infection in children
Creators: Puja J Umaretiya - From the
Jennifer B Swanson - Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
Hyo-Jin Kwon - Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
Charles Grose - Department of Pediatrics, University of Iowa Carver College of Medicine, Iowa City, Iowa, and
Christine M Lohse - Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
Young J Juhn - Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
Resource Type: Journal article
Publication Details: Allergy and asthma proceedings, Vol.37(3), pp.207-215
DOI: 10.2500/aap.2016.37.3951
PMID: 27178889
PMCID: PMC4846986
NLM abbreviation: Allergy Asthma Proc
ISSN: 1088-5412
eISSN: 1539-6304
Publisher: OceanSide Publications, Inc
Language: English
Date published: 2016
Academic Unit: Stead Family Department of Pediatrics; Infectious Disease (Pediatrics)
Record Identifier: 9984093504602771

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