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No increased risk of relapse after meningococcal C conjugate vaccine in nephrotic syndrome
  1. Brent Taylor (brent.taylor{at}medsch.ucl.ac.uk)
  1. Royal Free and University College Medical School, United Kingdom
    1. Nick Andrews (nick.andrews{at}hpa.org.uk)
    1. Health Protection Agency, United Kingdom
      1. Julia Stowe (julia.stowe{at}hpa.org.uk)
      1. Health Protection Agency, United Kingdom
        1. Laila Hamidi-Manesh (laila.hamidi{at}doctors.org.uk)
        1. University College Medical School, United Kingdom
          1. Elizabeth Miller (liz.miller{at}hpa.org.uk)
          1. Health Protection Agency, United Kingdom

            Abstract

            Objectives:To investigate whether meningococcal C conjugated vaccine (MCCV) caused relapse in children who have steroid-responsive nephrotic syndrome

            Design:

            i. Population-based study using an active surveillance system, developed to assess adverse events following vaccination, which linked hospital record information on relapses of nephrotic syndrome to community child health population MCCV data

            ii. Ecological study looking at hospital admissions for nephrotic syndrome before and after the MCCV introductory campaign, in different age-cohorts of children.

            Setting:

            i. A geographical area in south east England.

            ii. England

            Patients:

            i. 52 children having 162 relapses of nephrotic syndrome.

            ii. All hospital admissions with steroid responsive nephrotic syndrome in children age 2-18 years in England and Wales between 1995 and 2003, relating admissions to when MCCV was introduced in specific age-cohorts.

            Main outcome measures and analysis method:

            i. Self-controlled case-series analysis looking for increased risk of relapse following MCCV.

            ii. Changes in admission rates for nephrotic syndrome (incidence ratio) following the introduction of MCCV to different age-cohorts of children

            Results: There was no increased risk of relapse following MCCV:

            i. in the self-control case series - where a relative incidence of 0.95 (95% confidence intervals 0.61 – 1.47) was found in the 6 month post-vaccination period.

            ii. In the ecological study, which gave an incidence rate ratio of 1.05 (95% confidence intervals 0.95 to 1.15) for the quarter when MCCV was introduced and the following two quarters.

            Conclusions:We found no association between MCCV and nephrotic syndrome, which is therefore not a contraindication to meningococcal vaccination.

            • childhood nephrotic syndrome
            • meningococcal C conjugate vaccine
            • self-controlled case-series method
            • vaccine-associated adverse events

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