{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T18:02:04Z","timestamp":1788458524538,"version":"build-2803163510"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T00:00:00Z","timestamp":1658188800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005860","name":"Helsefonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005860","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003554","name":"Lundbeckfonden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003554","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007036","name":"Milj\u00f8styrelsen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100007036","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Contact Dermatitis"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Aluminium\u2010adsorbed vaccines may in some children cause severely itching nodules at the injection site, known as vaccination granulomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate vaccine\u2010, child\u2010 and maternal\u2010level risk factors for the development of vaccination granulomas following immunization with aluminium\u2010adsorbed vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A Danish population\u2010based cohort study with 553\u2009932 children born in Denmark from 1 January 2009 to 31 December 2018, vaccinated with an aluminium\u2010adsorbed vaccine during the first year of life, followed until 31 December 2020. Poisson regression was used to estimate granuloma rate ratios according to the type of adjuvant, accumulated dose of aluminium, timing of vaccination appointments, sex, gestational age, having siblings with granulomas, maternal age and maternal ethnicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified 1901 vaccination granuloma cases (absolute risk, 0.34%). Among vaccine level factors, revaccination (third vs. first vaccination appointment, adjusted rate ratio [RR] 1.26, 95% confidence interval [CI] 1.03\u20131.55), the specific adjuvant used (aluminium phosphate vs. hydroxide, RR 0.58, 95% CI 0.48\u20130.70) and dosage (\u22651.0\u00a0mg vs. &lt;1.0\u00a0mg, RR 1.34, 95% CI 1.19\u20131.52) were associated with risk of granulomas; the timing of vaccination appointments was not. Among child\u2010level factors, female sex (vs. males, RR 1.12, 95% CI, 1.02\u20131.22), prematurity (vs. term birth, RR 0.71, 95% CI, 0.54\u20130.93) and having sibling(s) with granulomas (vs. no siblings with granulomas, RR 46.15, 95% CI, 33.67\u201363.26) were associated with risk of granulomas. Among maternal\u2010level factors, non\u2010Danish ethnicity (vs. Danish, RR 0.51, 95% CI, 0.42\u20130.63) and young maternal age (&lt;20\u2009years vs. 20\u201339\u2009years, RR 0.46, 95% CI 0.25\u20130.83) were associated with risk of granulomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Several risk factors for vaccination granulomas at the vaccine, child and maternal levels, were identified. Reducing the dose of aluminium or replacing aluminium hydroxide with aluminium phosphate could reduce the risk of granulomas. However, this must be balanced against the potential for reduced immunogenicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cod.14180","type":"journal-article","created":{"date-parts":[[2022,7,2]],"date-time":"2022-07-02T05:28:35Z","timestamp":1656739715000},"page":"430-438","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Risk factors for granulomas in children following immunization with aluminium\u2010adsorbed vaccines: A Danish population\u2010based cohort study"],"prefix":"10.1111","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3983-2264","authenticated-orcid":false,"given":"Stine Skovbo","family":"Hoffmann","sequence":"first","affiliation":[{"name":"National Allergy Research Centre, Department of Dermatology and Allergy Herlev and Gentofte Hospital  Hellerup Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emilia Myrup","family":"Thiesson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research Statens Serum Institut  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3537-8463","authenticated-orcid":false,"given":"Jeanne Duus","family":"Johansen","sequence":"additional","affiliation":[{"name":"National Allergy Research Centre, Department of Dermatology and Allergy Herlev and Gentofte Hospital  Hellerup Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anders","family":"Hviid","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Research Statens Serum Institut  Copenhagen Denmark"},{"name":"Pharmacovigilance Research Centre, Department of Drug Design and Pharmacology University of Copenhagen  Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(02)00168-8"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2012.00406"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1986.tb01371.x"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1992.tb00123.x"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0264-410X(03)00531-0"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1982.tb00297.x"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1984.01650460058020"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-1409"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.2008.01474.x"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40169-016-0129-y"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2019.04.055"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xphs.2022.01.014"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0169-409X(98)00008-8"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13538"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2012-007779"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-012-1841-2"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.12053"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2020.00372"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.2340\/00015555-2432"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/DER.0000000000000836"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810387965"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1586\/14760584.5.5.641"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810394718"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0536.1980.tb04953.x"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-018-0356-1"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-014-2318-2"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2010.02.085"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/cod.13119"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0105-1873.2004.00299.x"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/DER.0000000000000787"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.1989.tb04162.x"},{"key":"e_1_2_9_33_1","unstructured":"PedersenFS Buch\u2010LarsenA.149 B\u00f8rn F\u00e5r erstatning: vaccine Gav dem Kl\u00f8e og Knuder. 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