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Letters Maternal vaccination against H1N1 influenza and offspring mortality

Concerns about study on maternal H1N1 influenza vaccination and offspring mortality

BMJ 2016; 352 doi: (Published 16 February 2016) Cite this as: BMJ 2016;352:i775
  1. Junya Makiyama, physician1,
  2. Michihiro Kono, clinical fellow2,
  3. Sayaka Shimizu, research associate3
  1. 1Department of Haematology, National Hospital Organization Nagasaki Medical Centre, Omura, Japan
  2. 2Department of Rheumatology, Endocrinology and Nephrology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  3. 3Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
  1. junya.makiyama{at}

We have three concerns about Ludvigsson and colleagues’ article on the association between maternal influenza A(H1N1)pdm09 vaccination during pregnancy and mortality in the offspring.1

Firstly, the authors defined exposure as vaccination during pregnancy. Accordingly, women who were vaccinated just before pregnancy were …

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