Vaccination and risk of lone atrial fibrillation in the active component United States military

Vaccination and risk of lone atrial fibrillation in the active component United States military

Purpose: To evaluate the hypothesis that receipt of anthrax vaccine adsorbed (AVA) increases the risk of atrial fibrillation in the absence of identifiable underlying risk factors or structural heart disease (lone atrial fibrillation). Methods: We conducted a retrospective population-based cohort st...

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Bibliographic Details
Published in:Human vaccines & immunotherapeutics Vol. 15; no. 3; pp. 669 - 676
Main Authors: McNeil, Michael M., Duderstadt, Susan K., Sabatier, Jennifer F., Ma, Gina G., Duffy, Jonathan
Format: Journal Article
Language:English
Published: United States Taylor & Francis 04-03-2019
Taylor & Francis Group
Subjects:
Adolescent
Adult
anthrax vaccine
Anthrax Vaccines - adverse effects
atrial fibrillation
Atrial Fibrillation - etiology
epidemiology
Female
Humans
Influenza Vaccines - adverse effects
Logistic Models
Male
Middle Aged
Military Personnel - statistics & numerical data
military vaccine surveillance
Odds Ratio
Poisson Distribution
Research Paper
Retrospective Studies
Risk Factors
Smallpox Vaccine - adverse effects
United States
Vaccination - adverse effects
vaccine safety
Young Adult
United States
vaccine safety
epidemiology
atrial fibrillation
military vaccine surveillance
anthrax vaccine
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Summary:Purpose: To evaluate the hypothesis that receipt of anthrax vaccine adsorbed (AVA) increases the risk of atrial fibrillation in the absence of identifiable underlying risk factors or structural heart disease (lone atrial fibrillation). Methods: We conducted a retrospective population-based cohort study among U.S. military personnel who were on active duty during the period from January 1, 1998 through December 31, 2006. International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes were used to identify individuals diagnosed with atrial fibrillation in the Defense Medical Surveillance System, and electronic records were screened to include only individuals without evidence of predisposing medical conditions. We used multivariable Poisson regression to estimate the risk of lone atrial fibrillation after exposure to AVA. We also evaluated possible associations with influenza and smallpox vaccines. Results: Our study population consisted of 2,957,091individuals followed for 11,329,746 person-years of service. Of these, 2,435 met our case definition for lone atrial fibrillation, contributing approximately 8,383 person-years of service. 1,062,176 (36%) individuals received at least one dose of AVA; the median person time observed post-exposure was 3.6 years. We found no elevated risk of diagnosed lone atrial fibrillation associated with AVA (adjusted risk ratio = 0.99; 95% confidence interval = 0.90, 1.09; p = 0.84). No elevated risk was observed for lone atrial fibrillation associated with influenza or smallpox vaccines given during military service. Conclusions: We did not find an increased risk of lone atrial fibrillation after AVA, influenza or smallpox vaccine. These findings may be helpful in planning future vaccine safety research.
Bibliography:Present address: Division of Global Health Protection, Center for Global Health, CDC
ISSN:2164-5515
2164-554X
DOI:10.1080/21645515.2018.1549453