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IJE Advance Access published online on June 10, 2005
International Journal of Epidemiology, doi:10.1093/ije/dyi113
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2005; all rights reserved.
Accepted May 5, 2005

Original paper

Vaccination history and risk of childhood leukaemia

Xiaomei Ma 1*, Monique B. Does 2, Catherine Metayer 2, Carolyn Russo 3, Alan Wong 3, and Patricia A. Buffler 2

1 Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, CT 06520-8034, USA
2 School of Public Health, University of California, Berkeley, CA 94720-7360, USA
3 Kaiser Permanente Northern California Region, Pediatric Oncology, 900 Kiely Blvd, Santa Clara, CA 95051, USA

* To whom correspondence should be addressed.
Xiaomei Ma, E-mail: xiaomei.ma{at}yale.edu


  Abstract

Background Previous studies on vaccination and childhood leukaemia generated inconsistent results.

Methods In the Northern California Childhood Leukaemia Study, a case-control study with incident cases and matched birth certificate controls, detailed written vaccination records were collected. A total of 323 cases aged 0-14 years at diagnosis and 409 controls were included in this analysis. All vaccinations were censored on the reference date (date of diagnosis for cases and the corresponding date for matched controls). Conditional logistic regression analysis was conducted, adjusting for potential confounding factors. A primary variable of interest is the number of administrations (doses) of various types of vaccines.

Results Vaccinations against diphtheria, pertussis, tetanus, poliomyelitis, measles, mumps, and rubella were not associated with the risk of leukaemia. The odds ratio for each dose of Haemophilus influenzae type b (Hib) vaccine was 0.81 (95% CI 0.68-0.96). Compared with children who received two or fewer doses of Hib vaccine, those who received three or more doses had a significantly reduced risk of childhood leukaemia (odds ratio = 0.55, 95% confidence interval 0.32-0.94). The number of doses of hepatitis B vaccine received was not associated with leukaemia risk.

Conclusions Hib vaccination is associated with a reduced risk of childhood leukaemia. Future studies with detailed exposure assessment and large sample sizes are needed to further address the role of vaccinations in the etiology of childhood leukaemia.

Keywords: Case-control studies; child; leukaemia; vaccination.
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