Table 1.
Pre-Specified Outcomes after MMR Administration.a
| Outcome | Diagnosis Setting | Risk Window | Control Windowb | ICD-9-CM Codesc | ICD-10-CM Codesd |
|---|---|---|---|---|---|
| Serious Outcomese | |||||
| Anaphylaxis | ED, IP | 0–2 days | 10–12 days | 995.0, 999.42 | T78.2*, T80.52*, T88.6* |
| Encephalitis/Myelitis | ED, IP | 1–42 days | 50–91 days | 055.0, 056.01, 072.2, 323.5*, 323.6*, 323.8*, 323.9, 348.30 | B05.0, B06.01, B26.2, G04.0*, G04.3*, G04.8*, G04.9*, G05.3, G05.4, G93.40 |
| GBS | ED, IP, OP | 1–42 days | 50–91 days | 357.0 | G61.0 |
| ITP | ED, IP, OP | 1–42 days | 50–91 days | 287.31 | D69.3 |
| Meningitis | ED, IP | 1–42 days | 50–91 days | 047.9, 055.79, 056.09, 072.1, 322.0 | A87.9, B05.1, B06.02, B26.1, G03.0 |
| Seizure | ED, IP | 0–42 days | 50–92 days | 345.80, 780.31, 780.32, 780.39 | G40.50*, G40.89, R56.0*, R56.9 |
| Non-Serious Outcomes | |||||
| Allergic Reaction | ED, IP, OP | 0–2 days | 10–12 days | 708.0, 708.1, 708.9, 995.1, 995.21, 995.27, 995.3 | L50.0, L50.1, L50.9, T78.3*, T78.4* |
| Arthropathy | ED, IP, OP | 6–14 days | 22–30 days | 716.4*, 716.5*, 716.6*, 716.9*, 719.4*, 719.5* | M12.9, M13.0, M13.1*, M25.5*, M25.6* |
| Fever | ED, IP, OP | 6–14 days | 22–30 days | 780.60, 780.61, 780.62, 780.63 | R50.81, R50.82, R50.83, R50.9 |
| Injection Site Reaction | ED, IP, OP | 1–6 days | 14–19 days | 680.3, 680.9, 682.3, 682.8, 682.9, 686.9, 729.5, 729.81 | L02.413, L02.414, L02.419, L02.423, L02.424, L02.429, L02.433, L02.434, L02.439, L02.9*, L03.113, L03.114, L03.119, L03.123, L03.124, L03.129, L03.818, L03.898, L03.9*, L08.9, M79.601, M79.602, M79.603, M79.609, M79.62*, M79.63*, M79.89 |
| Lymphadenopathy | ED, IP, OP | 6–14 days | 22–30 days | 289.3, 683, 785.6 | I88.8, I88.9, L04.2, L04.8, L04.9, R59.* |
| Non-Specific Reaction | ED, IP, OP | 0–6 days | 14–20 days | 979.4, 979.6, 979.9, 995.20, 995.29, 999.39, 999.9, E949.4, E949.6, E949.9 | T50.901*, T50.905*, T50.991*, T50.995*, T50.B91*, T50.B95*, T50.Z91*, T50.Z95*, T78.8*, T80.29*, T88.0*, T88.1*, T88.7*, T88.9* |
| Parotitis | ED, IP, OP | 6–14 days | 22–30 days | 527.2 | K11.20, K11.21 |
| Rash | ED, IP, OP | 6–14 days | 22–30 days | 782.1 | R21 |
| Syncope | ED, IP, OP | Day 0 | Day 8 | 458.29, 458.8, 458.9, 780.2 | I95.2, I95.8*, I95.9, R55 |
Abbreviations: MMR = measles, mumps, and rubella vaccine; ED = emergency department; IP = inpatient; OP = outpatient; ICD-9-CM = International Classification of Diseases, Ninth Revision, Clinical Modification; ICD-10-CM = International Classification of Diseases, Tenth Revision, Clinical Modification; *=wildcard; GBS = Guillain-Barré syndrome; ITP = immune thrombocytopenia.
For all pre-specified outcomes, events were considered incident if the diagnosis code that appeared in the post-vaccination window was the first occurrence of a diagnosis code for that outcome in 60 days.
Control windows were designed to be the same length (i.e., number of days) as the risk windows, with a washout period of 7 days between the risk window and control window.
ICD-9-CM were used to identify outcomes prior to October 1, 2015.
ICD-10-CM were used to identify outcomes on or after October 1, 2015.
Medical record reviews were conducted for all serious outcomes to confirm electronic diagnoses.