{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T23:17:48Z","timestamp":1790119068061,"version":"4.0.1"},"reference-count":44,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,9,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Live attenuated vaccines such as oral polio vaccine (OPV) can stimulate innate immunity and may have off-target protective effects on other pathogens. We aimed to address this hypothesis by examining changes in infectious diseases (ID)-related hospitalizations in all hospital discharges in California during OPV (1985\u20131996) and non-OPV immunization periods (2000\u20132010).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched the Office of Statewide Health Planning and Development database for all hospital discharges with any ID-related discharge diagnosis code during 1985\u20132010. We compared the proportion of ID-related hospitalizations (with at least &amp;#x2028;1 ID-related discharge diagnosis) among total hospitalizations during OPV immunization (1985\u20131996) versus non-OPV immunization (2000\u20132010) periods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 19 281 039 ID-related hospitalizations (8 464 037 with an ID-related discharge diagnosis as the principal discharge diagnosis for the hospitalization) among 98 117 475 hospitalizations in 1985\u20132010; 9 520 810 ID hospitalizations\/43 456 484 total hospitalizations in 2000\u20132010 versus 7 526 957\/43 472 796 in 1985\u20131996. The risk ratio for ID-related hospitalizations in 2000\u20132010 versus 1985\u20131996 was 1.27 (95% confidence interval [CI], 1.26\u20131.27) for all diagnoses and 1.15 (95% CI: 1.15\u20131.16) for principal diagnoses. Increases also existed in the proportion of lower respiratory and gastrointestinal infections.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>The proportion of ID-related hospitalizations was lower in the OPV immunization period compared to the period after OPV was discontinued. When focused only on hospitalizations with ID as the principal discharge diagnosis, the signal remained significant but was smaller. These findings require replication in additional studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/cid\/ciac114","type":"journal-article","created":{"date-parts":[[2022,2,5]],"date-time":"2022-02-05T04:33:35Z","timestamp":1644035615000},"page":"1123-1130","source":"Crossref","is-referenced-by-count":3,"title":["Infectious Diseases-Related Hospitalizations During Oral Polio Vaccine (OPV) and Non-OPV Immunization Periods: An Empirical Evaluation of all Hospital Discharges in California (1985\u20132010)"],"prefix":"10.1093","volume":"75","author":[{"given":"Despina G","family":"Contopoulos-Ioannidis","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine , Stanford, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Altamirano","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine , Stanford, California , USA"},{"name":"Department of Epidemiology and Population Health, Stanford University School of Medicine , Stanford, California , USA"},{"name":"Office of Faculty Development and Diversity, Stanford University , Stanford, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Pediatrics, Stanford University School of Medicine , Stanford, California , USA"},{"name":"Department of Epidemiology and Population Health, Stanford University School of Medicine , Stanford, California , USA"},{"name":"Office of Faculty Development and Diversity, Stanford University , Stanford, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,2,9]]},"reference":[{"key":"2022093020234251400_CIT0001","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1038\/s41590-020-00845-6","article-title":"Trained immunity, tolerance, priming and differentiation: distinct immunological processes.","volume":"22","author":"Divangahi","year":"2021","journal-title":"Nat Immunol"},{"key":"2022093020234251400_CIT0002","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1126\/science.abc4262","article-title":"Can existing live vaccines prevent COVID-19?","volume":"368","author":"Chumakov","year":"2020","journal-title":"Science"},{"key":"2022093020234251400_CIT0003","doi-asserted-by":"crossref","first-page":"e2101718118","DOI":"10.1073\/pnas.2101718118","article-title":"Old vaccines for new infections: exploiting innate immunity to control COVID-19 and prevent future pandemics.","volume":"118","author":"Chumakov","year":"2021","journal-title":"Proc Natl Acad Sci USA"},{"key":"2022093020234251400_CIT0004","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1016\/j.cell.2020.04.042","article-title":"Trained immunity: a tool for reducing susceptibility to and the severity of SARS-CoV-2 infection.","volume":"181","author":"Netea","year":"2020","journal-title":"Cell"},{"issue":"8","key":"2022093020234251400_CIT0005","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1001\/jama.2014.470","article-title":"Live vaccine against measles, mumps, and rubella and the risk of hospital admissions for nontargeted infections.","volume":"311","author":"Sorup","year":"2014","journal-title":"JAMA"},{"key":"2022093020234251400_CIT0006","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.it.2013.04.004","article-title":"Small jab - a big effect: nonspecific immunomodulation by vaccines.","volume":"34","author":"Benn","year":"2013","journal-title":"Trends Immunol"},{"key":"2022093020234251400_CIT0007","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1038\/ni.2961","article-title":"Nonspecific effects of neonatal and infant vaccination: public-health, immunological and conceptual challenges.","volume":"15","author":"Aaby","year":"2014","journal-title":"Nat Immunol"},{"key":"2022093020234251400_CIT0008","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1038\/nri.2016.43","article-title":"Harnessing the beneficial heterologous effects of vaccination.","volume":"16","author":"Goodridge","year":"2016","journal-title":"Nat Rev Immunol"},{"key":"2022093020234251400_CIT0009","doi-asserted-by":"crossref","first-page":"1696","DOI":"10.1001\/jama.292.14.1696","article-title":"Vaccine policy changes and epidemiology of poliomyelitis in the United States.","volume":"292","author":"Alexander","year":"2004","journal-title":"JAMA"},{"key":"2022093020234251400_CIT0010","article-title":"Stata module to calculate adjusted probabilities from logistic regression estimates.","author":"Garrett","year":"1998","journal-title":"ADJPROP: Statistical Software Components S344804, Boston College Department of Economics"},{"key":"2022093020234251400_CIT0011","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.ebiom.2016.07.016","article-title":"Revaccination with live attenuated vaccines confer additional beneficial nonspecific effects on overall survival: a review.","volume":"10","author":"Benn","year":"2016","journal-title":"EBioMedicine"},{"key":"2022093020234251400_CIT0012","doi-asserted-by":"crossref","first-page":"e274","DOI":"10.1016\/S1473-3099(19)30742-X","article-title":"Vaccinology: time to change the paradigm?","volume":"20","author":"Benn","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2022093020234251400_CIT0013","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.smim.2018.06.002","article-title":"Non-specific effects of vaccines: current evidence and potential implications.","volume":"39","author":"de Bree","year":"2018","journal-title":"Semin Immunol"},{"key":"2022093020234251400_CIT0014","doi-asserted-by":"crossref","first-page":"c6495","DOI":"10.1136\/bmj.c6495","article-title":"Non-specific effects of standard measles vaccine at 4.5 and 9 months of age on childhood mortality: randomised controlled trial.","volume":"341","author":"Aaby","year":"2010","journal-title":"BMJ"},{"key":"2022093020234251400_CIT0015","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1016\/j.cmi.2019.05.024","article-title":"Heterologous effects of vaccination and trained immunity.","volume":"25","author":"Gyssens","year":"2019","journal-title":"Clin Microbiol Infect"},{"key":"2022093020234251400_CIT0016","doi-asserted-by":"crossref","first-page":"e596","DOI":"10.1093\/cid\/ciaa1351","article-title":"National immunization campaigns with oral polio vaccine may reduce all-cause mortality: an analysis of 13 years of demographic surveillance data from an urban African area.","volume":"72","author":"Andersen","year":"2021","journal-title":"Clin Infect Dis"},{"key":"2022093020234251400_CIT0017","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3389\/fpubh.2018.00013","article-title":"National immunization campaigns with oral polio vaccine (OPV) reduce the general all-cause mortality rate: an analysis of the effect of campaign-OPV on child mortality within seven randomised trials.","volume":"6","author":"Andersen","year":"2018","journal-title":"Front Public Health"},{"key":"2022093020234251400_CIT0018","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1016\/j.vaccine.2016.11.006","article-title":"Campaigns with oral polio vaccine may lower mortality and create unexpected results.","volume":"35","author":"Benn","year":"2017","journal-title":"Vaccine"},{"key":"2022093020234251400_CIT0019","doi-asserted-by":"crossref","first-page":"100886","DOI":"10.1016\/j.eclinm.2021.100886","article-title":"National immunisation campaigns with oral polio vaccine may reduce all-cause mortality: analysis of 2004-2019 demographic surveillance data in rural Bangladesh.","volume":"36","author":"Nielsen","year":"2021","journal-title":"EClinicalMedicine"},{"key":"2022093020234251400_CIT0020","first-page":"123","article-title":"Sabin\u2019s vaccine used for nonspecific prevention of infant diarrhea of viral etiology.","volume":"8","author":"Contreras","year":"1974","journal-title":"Bull Pan Am Health Organ"},{"key":"2022093020234251400_CIT0021","doi-asserted-by":"crossref","first-page":"1746","DOI":"10.1016\/j.vaccine.2004.02.054","article-title":"Childhood mortality after oral polio immunisation campaign in Guinea-Bissau.","volume":"23","author":"Aaby","year":"2005","journal-title":"Vaccine"},{"key":"2022093020234251400_CIT0022","doi-asserted-by":"crossref","first-page":"3014","DOI":"10.1016\/j.vaccine.2004.02.009","article-title":"Oral polio vaccination and low case fatality at the paediatric ward in Bissau, Guinea-Bissau.","volume":"22","author":"Aaby","year":"2004","journal-title":"Vaccine"},{"key":"2022093020234251400_CIT0023","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1016\/0264-410X(89)90230-2","article-title":"Effect of the administration of oral poliovirus vaccine on infantile diarrhoea mortality.","volume":"7","author":"Contreras","year":"1989","journal-title":"Vaccine"},{"key":"2022093020234251400_CIT0024","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1093\/cid\/civ617","article-title":"The effect of oral polio vaccine at birth on infant mortality: a randomized trial.","volume":"61","author":"Lund","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2022093020234251400_CIT0025","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1093\/cid\/cix354","article-title":"Nonspecific effects of oral polio vaccine on diarrheal burden and etiology among Bangladeshi infants.","volume":"65","author":"Upfill-Brown","year":"2017","journal-title":"Clin Infect Dis"},{"key":"2022093020234251400_CIT0026","doi-asserted-by":"crossref","first-page":"ofv204","DOI":"10.1093\/ofid\/ofv204","article-title":"Oral polio vaccination and hospital admissions with non-polio infections in Denmark: nationwide retrospective cohort study.","volume":"3","author":"Sorup","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"2022093020234251400_CIT0027","doi-asserted-by":"crossref","first-page":"8615","DOI":"10.1016\/j.vaccine.2011.09.015","article-title":"Viral interference induced by live attenuated virus vaccine (OPV) can prevent otitis media.","volume":"29","author":"Seppala","year":"2011","journal-title":"Vaccine"},{"key":"2022093020234251400_CIT0028","first-page":"233","article-title":"Meeting of the Strategic Advisory Group of Experts on immunization, April 2014 -conclusions and recommendations.","volume":"89","year":"2014","journal-title":"Week Epidemiol Rec"},{"key":"2022093020234251400_CIT0029","doi-asserted-by":"crossref","first-page":"i5170","DOI":"10.1136\/bmj.i5170","article-title":"Association of BCG, DTP, and measles containing vaccines with childhood mortality: systematic review.","volume":"355","author":"Higgins","year":"2016","journal-title":"BMJ"},{"key":"2022093020234251400_CIT0030","author":"Tranet"},{"key":"2022093020234251400_CIT0031","article-title":"OPV as Potential Protection Against COVID-19 (The Bandim Health Project)","author":"Fisker"},{"key":"2022093020234251400_CIT0032","article-title":"CROWN CORONATION: COVID-19 Research Outcomes Worldwide Network for CORONAvirus prevention (CROWN CORONA)","author":"Avidan"},{"key":"2022093020234251400_CIT0033","doi-asserted-by":"crossref","first-page":"632478","DOI":"10.3389\/fimmu.2021.632478","article-title":"The BCG vaccine for COVID-19: first verdict and future directions.","volume":"12","author":"Gonzalez-Perez","year":"2021","journal-title":"Front Immunol"},{"key":"2022093020234251400_CIT0034","article-title":"BCG Vaccine for Health Care Workers as Defense Against COVID 19 (BADAS)","author":"Cirillo"},{"key":"2022093020234251400_CIT0035","doi-asserted-by":"publisher","DOI":"10.1101\/2021.05.20.21257520","article-title":"Activate-2: a double-blind randomized trial of BCG vaccination against COVID19 in individuals at risk.","author":"Tsilika","journal-title":"medRxiv preprint"},{"key":"2022093020234251400_CIT0036","article-title":"Using BCG to Protect Senior Citizens During the COVID-19 Pandemic. ClinicalTrials.gov NCT04542330","author":"Rosendahl Madsen"},{"key":"2022093020234251400_CIT0037","article-title":"Efficacy of BCG Vaccination in the Prevention of COVID19 Via the Strengthening of Innate Immunity in Health Care Workers (COVID-BCG)","author":"Launay"},{"key":"2022093020234251400_CIT0038","article-title":"Clinical Trial Evaluating the Effect of BCG Vaccination on the Incidence and Severity of SARS-CoV-2 Infections Among Healthcare Professionals During the COVID-19 Pandemic in Poland","author":"Czajka"},{"key":"2022093020234251400_CIT0039","author":"BCG Vaccination for Healthcare Workers in COVID-19 Pandemic"},{"key":"2022093020234251400_CIT0040","article-title":"BCG to Reduce Absenteeism Among Health Care Workers During the COVID-19 Pandemic (EDCTP)","author":"Benn"},{"key":"2022093020234251400_CIT0041","article-title":"COVID-19: BCG As Therapeutic Vaccine, Transmission Limitation, and Immunoglobulin Enhancement (BATTLE)","author":"Reis"},{"key":"2022093020234251400_CIT0042","article-title":"Use of BCG Vaccine as a Preventive Measure for COVID-19 in Health Care Workers (ProBCG)","author":"Silva"},{"key":"2022093020234251400_CIT0043","article-title":"BCG Vaccine in Reducing Morbidity and Mortality in Elderly Individuals in COVID-19 Hotspots","author":"Chandrasekaran"},{"key":"2022093020234251400_CIT0044","doi-asserted-by":"publisher","DOI":"10.1101\/2021.09.14.21263598","article-title":"Efficacy of measles-mumps-rubella (MMR) vaccine in reducing the severity of COVID-19: an interim analysis of a randomised controlled clinical trial.","author":"Fedrizzi","journal-title":"medRxiv [preprint]"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciac114\/43707647\/ciac114.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/7\/1123\/46227290\/ciac114.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/article-pdf\/75\/7\/1123\/46227290\/ciac114.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T20:30:26Z","timestamp":1664569826000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/article\/75\/7\/1123\/6525447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,9]]},"references-count":44,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,2,9]]},"published-print":{"date-parts":[[2022,9,30]]}},"URL":"https:\/\/doi.org\/10.1093\/cid\/ciac114","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,10,1]]},"published":{"date-parts":[[2022,2,9]]}}}