Vaccination and 30-Day Mortality Risk in Children, Adolescents, and Young Adults

Pediatrics. 2016 Mar;137(3):e20152970. doi: 10.1542/peds.2015-2970. Epub 2016 Feb 1.


Objective: This study evaluates the potential association of vaccination and death in the Vaccine Safety Datalink (VSD).

Methods: The study cohort included individuals ages 9 to 26 years with deaths between January 1, 2005, and December 31, 2011. We implemented a case-centered method to estimate a relative risk (RR) for death in days 0 to 30 after vaccination.Deaths due to external causes (accidents, homicides, and suicides) were excluded from the primary analysis. In a secondary analysis, we included all deaths regardless of cause. A team of physicians reviewed available medical records and coroner's reports to confirm cause of death and assess the causal relationship between death and vaccination.

Results: Of the 1100 deaths identified during the study period, 76 (7%) occurred 0 to 30 days after vaccination. The relative risks for deaths after any vaccination and influenza vaccination were significantly lower for deaths due to nonexternal causes (RR 0.57, 95% confidence interval [CI] 0.38-0.83, and RR 0.44, 95% CI 0.24-0.80, respectively) and deaths due to all causes (RR 0.72, 95% CI 0.56-0.91, and RR 0.44, 95% CI 0.28-0.65). No other individual vaccines were significantly associated with death. Among deaths reviewed, 1 cause of death was unknown, 25 deaths were due to nonexternal causes, and 34 deaths were due to external causes. The causality assessment found no evidence of a causal association between vaccination and death.

Conclusions: Risk of death was not increased during the 30 days after vaccination, and no deaths were found to be causally associated with vaccination.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Cause of Death / trends
  • Child
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Population Surveillance / methods*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Survival Rate / trends
  • Time Factors
  • United States / epidemiology
  • Vaccination / adverse effects*
  • Vaccination / mortality*
  • Young Adult