| Safety: aseptic meningitis |
|
Patient or population: children 9 months to 15 years old
Setting: general population
Intervention: MMR vaccine
Comparison: unvaccinated |
| Outcomes |
Anticipated absolute effects* (95% CI) |
Relative effect
(95% CI) |
№ of participants
(studies) |
Certainty of the evidence
(GRADE) |
| Risk of aseptic meningitis
amongst unvaccinated |
Risk of aseptic meningitis
amongst vaccinated |
| Case‐control ‐ Jeryl Lynn ‐ risk interval 0 to 30 days |
Study population |
OR 0.85
(0.21 to 3.41) |
59 cases, 118 controls
(1 observational study) |
⊕⊕⊝⊝
LOW |
| 59 per 1000 |
51 per 1000
(13 to 177) |
| Case cross‐over ‐ Urabe or Hoshino |
Study population |
OR 4.00
(2.23 to 7.20) |
(2 observational studies) |
⊕⊕⊝⊝
LOW |
| 0 per 1000 |
0 per 1000
(0 to 0) |
| Case cross‐over ‐ Jeryl Lynn or Rubini |
Study population |
OR 0.60
(0.18 to 1.99) |
(1 observational study) |
⊕⊕⊝⊝
LOW |
| 0 per 1000 |
0 per 1000
(0 to 0) |
| Self‐controlled case series ‐ any strain |
Study population |
Rate ratio 12.40
(3.12 to 49.35) |
(1 observational study) |
⊕⊕⊝⊝
LOW |
| 0 per 1000 |
0 per 1000
(0 to 0) |
| Self‐controlled case series ‐ Urabe |
Study population |
Rate ratio 30.71
(13.45 to 70.10) |
564,635
(3 observational studies) |
⊕⊕⊝⊝
LOW |
| 16 per 100,000 |
490 per 100,000
(214 to 1.117) |
| Self controlled case series ‐ Leningrad‐Zagreb |
Study population |
Rate ratio 6.40
(0.78 to 52.47) |
(1 observational study) |
⊕⊕⊝⊝
LOW |
| 0 per 1000 |
0 per 1000
(0 to 0) |
| Person‐time cohort ‐ Jeryl Lynn |
Study population |
Rate ratio 1.30
(0.66 to 2.56) |
1,071,088
(1 observational study) |
⊕⊕⊝⊝
LOW |
| 30 per 100,000 |
39 per 100,000
(20 to 77) |
| Case‐only ecological method ‐ Urabe |
Study population |
Rate ratio 9.12
(5.73 to 14.52) |
1,054,305
(1 observational study) |
⊕⊕⊝⊝
LOW |
| 9 per 100,000 |
80 per 100,000
(51 to 128) |
| Case‐only ecological method ‐ Leningrad‐Zagreb |
Study population |
Rate ratio 18.56
(12.09 to 28.51) |
1,164,964
(3 observational studies) |
⊕⊕⊝⊝
LOW |
| 0 per 100,000 |
0 per 100,000
(0 to 0) |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; MMR: measles, mumps, rubella vaccine; OR: odds ratio |
|
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. |
