2275. Parental Risk Factors for Fever in their Children 7–10 Days After the First Dose of Measles-Containing Vaccines

Abstract

BackgroundFever 7–10 days after the first dose of a measles-containing vaccines (MCV) clusters among siblings in families suggesting a genetic basis. To further investigate this association, we evaluated whether clinical conditions in parents are associated with fever after a first dose of MCV in the child.MethodsWe conducted a cohort study including children born in Kaiser Permanente Northern California between 2009 and 2016 who received an MCV between ages 1 and 2 years. Each child was linked with his/her mother and father (where possible). We defined MCV- associated fever as a clinic or emergency department visit with fever code 7-10 days after the first dose of an MCV and identified parental clinical conditions present before or after child birth in electronic health record data. We evaluated parental clinical conditions associated with MCV-associated fever in the child using chi square or T test and multivariable logistic regression analysesResultsThe study included 244,128 children, 192,253 mothers (100 % of children) and 118,046 fathers (59% of children). There were 3750 children (1.54%) with MCV-associated fever. We identified more than 1000 separate clinical conditions in the parents, of which 29 maternal and 11 paternal conditions were significantly associated with MCV-associated fever in the child. After adjustment for maternal and infant covariates, including healthcare seeking behavior, maternal fever (odds ratios [OR] 1.18, 95% confidence interval [CI] 1.06–1.32), respiratory infection with fever (OR 1.20, 95% CI 1.09–1.31), maternal fever after a MCV (OR 5.90, 95% CI 1.35–25.78), migraines (OR 1.14, 95% CI 1.05–1.24), syncope (OR 1.14, 95% CI 1.01–1.27), arrhythmia (OR 1.21, 95% CI 1.00–1.45), essential thrombocythemia (OR 1.93, 95% CI 1.15–3.25) and Addison’s disease (OR 2.90, 95% CI 0.90–9.33) were significantly associated with infant fever after a MCV. Paternal fever (OR 1.44, 95% CI 1.20–1.72) and (OR 1.60, 95% CI 1.03–2.48) were associated with MCV-associated fever in the childConclusionSpecific parental immune factors were associated with fever in their child 7–10 days after an MCV. These results imply that risk for fever after MCV may be related generally to genetics and particularly to familial immune responsesDisclosures N. P. Klein, Sanofi Pasteur: Investigator, Research grant. Merck: Investigator, Research grant. GSK: Investigator, Research grant. Pfizer: Investigator, Research support. Protein Science: Investigator, Research grant. MedImmune: Investigator, Research grant. Dynavax: Research Contractor, Grant recipient.