Methodology for computing the burden of disease of adverse events following immunization

Scott A. Mcdonald*, Danielle Nijsten, Kaatje Bollaerts, Jorgen Bauwens, Nicolas Praet, Marianne van der Sande, Vincent Bauchau, Tom de Smedt, Miriam Sturkenboom, Susan Hahné

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose: Composite disease burden measures such as disability-adjusted life-years (DALY) have been widely used to quantify the population-level health impact of disease or injury, but application has been limited for the estimation of the burden of adverse events following immunization. Our objective was to assess the feasibility of adapting the DALY approach for estimating adverse event burden. Methods: We developed a practical methodological framework, explicitly describing all steps involved: acquisition of relative or absolute risks and background event incidence rates, selection of disability weights and durations, and computation of the years lived with disability (YLD) measure, with appropriate estimation of uncertainty. We present a worked example, in which YLD is computed for 3 recognized adverse reactions following 3 childhood vaccination types, based on background incidence rates and relative/absolute risks retrieved from the literature. Results: YLD provided extra insight into the health impact of an adverse event over presentation of incidence rates only, as severity and duration are additionally incorporated. As well as providing guidance for the deployment of DALY methodology in the context of adverse events associated with vaccination, we also identified where data limitations potentially occur. Conclusions: Burden of disease methodology can be applied to estimate the health burden of adverse events following vaccination in a systematic way. As with all burden of disease studies, interpretation of the estimates must consider the quality and accuracy of the data sources contributing to the DALY computation.

Original languageEnglish
Pages (from-to)724-730
Number of pages7
JournalPharmacoepidemiology and Drug Safety
Issue number7
Early online date2018
Publication statusPublished - Jul 2018
Externally publishedYes


  • Adverse events
  • Disability-adjusted life-years
  • Disease burden
  • Methodology
  • Pharmacoepidemiology
  • Vaccination


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