Published online June 1, 2005
PEDIATRICS Vol. 115 No. 6 June 2005, pp. e643-e646 (doi:10.1542/peds.2004-2185)
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ELECTRONIC ARTICLE

Probability of Coincident Vaccination in the 24 or 48 Hours Preceding Sudden Infant Death Syndrome Death in Australia

Julia M.L. Brotherton, BMed, MPH, GradDipAppEpi*, Brynley P. Hull, BSc, MPH*, Andrew Hayen, PhD{ddagger}, Heather F. Gidding, BAppSc(Biomed), GradDipEpidBiostats, MAppEpid, MASM* and Margaret A. Burgess, MD*

* National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Children's Hospital at Westmead and the University of Sydney, Sydney, New South Wales, Australia
{ddagger} New South Wales Department of Health, North Sydney, New South Wales, Australia

Objective. Vaccination does not cause sudden infant death syndrome (SIDS). However, SIDS peaks at 2 months of age, when vaccination encounters are frequent. There are no published estimates using population data on age of death and immunization coverage to indicate to practitioners how often coincident vaccination may occur by chance. This study aimed to determine the probability that an Australian infant who has died of SIDS was vaccinated in the days before death.

Methods. An analytical study of population death data and immunization coverage was conducted for Australian children who were born between April 1, 2002, and March 31, 2003. Also evaluated were Australian children who were registered as dying of SIDS between 1997 and 2001. The main outcomes measured were distribution of SIDS deaths by age and distribution of immunization coverage by age.

Results. The probability of recent vaccination and SIDS coinciding varied by age and day of the week of death. The overall estimated probability of vaccination within the last 24 hours for a child who has died of SIDS in Australia is estimated as 1.3%. In the last 48 hours, it is 2.6%. With the average number of SIDS deaths for the period 1997–2001 equal to 130 cases per year, we estimated that a case of SIDS will occur when vaccination was given in the last 24 hours in 1.7 cases per year and within 48 hours in 3.5 cases.

Conclusions. Although coincident vaccination and SIDS should not be a frequent problem, it can be expected to occur at least annually in Australia by chance alone. The probabilities of vaccination by age estimated in this study can also be applied to estimate the probability of a vaccination encounter for children who have experienced any unusual medical condition or death, when these occurrences are known to be unrelated to vaccination.

Key Words: sudden infant death • immunization • vaccination • probability • Australia

Abbreviations: ACIR, Australian Childhood Immunisation Register • SIDS, sudden infant death syndrome

Accepted Dec 8, 2004.


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