{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T21:48:23Z","timestamp":1771364903778,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2004,5,21]],"date-time":"2004-05-21T00:00:00Z","timestamp":1085097600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Statistics in Medicine"],"published-print":{"date-parts":[[2004,6,30]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Vaccination is quite effective in reducing the incidence of disease. However, it may cause some adverse events. For example, one of the adverse events of measles\u2010mumps\u2010rubella(MMR) vaccination is the occurrence of aseptic meningitis. Since the vaccination rate is usually quite high, it is not plausible to use popular study designs such as cohort or case\u2010control studies. We considered a case cross\u2010over design to investigate the association between MMR vaccination and aseptic meningitis in Korean children. We used the Cochran\u2013Mantel\u2013Haenszel(CMH) approach, and obtained a Mantel\u2013Haenszel odds ratio estimator as a measure of association. However, the validity of case cross\u2010over design or the CMH approach in vaccine adverse studies has not been fully investigated. In this paper, through Monte Carlo simulation studies, we show the appropriateness of the case cross\u2010over design and the CMH approach. We also discuss alternative approaches such as Poisson regression using offset and a simple uniformity test. In conclusion, the case cross\u2010over design seems useful to investigate the association between vaccination and occurrence of acute adverse events. 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