Kawasaki Disease and Vaccination: Prospective Case-Control and Case-Crossover Studies among Infants in Japan
Kenji Murata,
Sagano Onoyama,
Kenichiro Yamamura,
Yumi Mizuno,
Kenji Furuno,
Keita Matsubara,
Ken Hatae,
Kiminori Masuda,
Yuichi Nomura,
Takuro Ohno,
Akiko Kinumaki,
Masaru Miura,
Yasunari Sakai,
Shouichi Ohga,
Wakaba Fukushima,
Junji Kishimoto,
Yosikazu Nakamura,
Toshiro Hara
Affiliations
Kenji Murata
Kawasaki Disease Center, Fukuoka Children’s Hospital, Fukuoka 813–0017, Japan
Sagano Onoyama
Kawasaki Disease Center, Fukuoka Children’s Hospital, Fukuoka 813–0017, Japan
Kenichiro Yamamura
Department of Perinatal and Pediatric Medicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812–8582, Japan
Yumi Mizuno
Kawasaki Disease Center, Fukuoka Children’s Hospital, Fukuoka 813–0017, Japan
Kenji Furuno
Kawasaki Disease Center, Fukuoka Children’s Hospital, Fukuoka 813–0017, Japan
Keita Matsubara
Department of Pediatrics, Hiroshima City Funairi Citizens Hospital, Hiroshima 730–0844, Japan
Ken Hatae
Department of Pediatrics, Japanese Red Cross Fukuoka Hospital, Fukuoka 815–8555, Japan
Kiminori Masuda
Department of Pediatrics, Kagoshima City Hospital, Kagoshima 890–8760, Japan
Yuichi Nomura
Department of Pediatrics, Kagoshima City Hospital, Kagoshima 890–8760, Japan
Takuro Ohno
Department of Pediatrics, Oita Prefectural Hospital, Oita 870–8511, Japan
Akiko Kinumaki
Department of General Pediatrics, Tokyo Metropolitan Children’s Medical Center, Fuchu, Tokyo 183–8561, Japan
Masaru Miura
Department of Cardiology, Tokyo Metropolitan Children’s Medical Center, Fuchu, Tokyo 183–8561, Japan
Yasunari Sakai
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812–8582, Japan
Shouichi Ohga
Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812–8582, Japan
Wakaba Fukushima
Department of Public Health, Research Center for Infectious Disease Sciences, Osaka City University Graduate School of Medicine, Osaka City University, Osaka 558–8585, Japan
Junji Kishimoto
Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka 812–8582, Japan
Yosikazu Nakamura
Department of Public Health, Jichi Medical University, Shimotsuke 329–0498, Japan
Toshiro Hara
Kawasaki Disease Center, Fukuoka Children’s Hospital, Fukuoka 813–0017, Japan
The causal effects of vaccines on Kawasaki disease (KD) remain elusive. We aimed to examine the association between vaccines administered during infancy and the development of KD in Japan. We conducted a multicenter prospective case-control study using questionnaires and compared the vaccination status of infants (age: 6 weeks to 9 months) who developed KD (KD group; n = 102) and those who did not develop KD (non-KD group; n = 139). Next, we performed a case-crossover study of 98 cases in the KD group and compared the status of vaccinations between the case and control periods. We also compared the incidence of KD in children for each 5-year period before and after the addition of new vaccines (2012–2013) using data from the Nationwide Survey of KD. In the case-control study, the vaccination status of the KD and control groups did not differ to a statistically significant extent. Multivariable analysis of the vaccination status and patient backgrounds showed no significant association between vaccination and KD development. In the case-crossover study, the status of vaccinations during the case and control periods did not differ to a statistically significant extent. In the analysis of data from the Nationwide Survey of KD, the incidence of KD in children of ages subject to frequent vaccination showed no significant increases in the latter five years, 2014–2018. Based on these prospective analyses, we confirmed that vaccination in early infancy did not affect the risk of KD.
