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Volume 10, Number 5—May 2004
Letter

Smallpox Vaccination and Adverse Cardiac Events

Mark J. Upfal*Comments to Author  and Sandro Cinti†
Author affiliations: *Detroit Medical Center, Detroit, Michigan, USA; †University of Michigan, Ann Arbor, Michigan, USA

Main Article

Table

Smallpox vaccination and estimated risk for cardiac death

          All cardiac deathsa           Atherosclerotic deathsa,b           All cardiac deaths, civilians onlyc
Estimated vaccine-associated death risk (deaths/vaccinees) based on 2003 experienced
           6.1 per million (3/488,550)
           6.1 per million (3/488,550)
           52.3 per million (2/38,257)
1947 rate of cardiac deaths in 2-week risk period (deaths/vaccinees)
           241 per million (1,545/6.4 million)
           44 per million (280/6.4 million)
           44 per million (280/6.4 million)
Percent of 1947 deaths that would have been due to vaccination, given estimated vaccine-associated risk           2.5%           14.0%           100%
Sufficient power to detect?           Possibly           Definitely           Definitely

aFor these estimates, we used the total number of vaccinees as of November 2003, per Upfal’s letter. Our original article estimated risk based on 394,584 vaccinees as of April 2003; the resulting effect size would be even larger and more easily detectable.
bAll cardiac deaths in 2003 were atherosclerotic.
cFor this calculation, we used the total number of civilian vaccinees as of August 2003, per Upfal’s letter. Our original article estimated risk based on 29,584 civilian vaccinees as of April 2003; the resulting effect size would be even larger and more easily detectable.
dEstimated risk for death caused by vaccine, if one assumes that all 2003 cardiac deaths were vaccine-related.

Main Article

Page created: April 23, 2012
Page updated: April 23, 2012
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The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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