Andersson · Annals of internal medicine 2025 · nationwide retrospective cohort study · n=1224176

Aluminum-Adsorbed Vaccines and Chronic Diseases in Childhood : A Nationwide Cohort Study.

Cited 32 times in the scientific literature.

Level 3 - non-randomized controlled study

Nationwide non-randomized registry-based cohort study

PubMed 40658954 · doi:10.7326/ANNALS-25-00997 · record verified 2026-08-31

What was done

A nationwide registry-based cohort study in Denmark evaluated 1,224,176 children born between 1997 and 2018 who were alive and residing in the country at age 2 years, with follow-up from 1997 to 2020. Nationwide registries were linked to obtain childhood vaccination records, diagnostic codes, and potential confounders. The exposure measured was cumulative aluminum received (per 1-mg increase) via vaccination during the first 2 years of life. Outcomes included incident events across 50 chronic disorders categorized into autoimmune, atopic or allergic, and neurodevelopmental conditions.

What was found

Cumulative aluminum exposure from vaccination during the first 2 years of life was not associated with increased rates of any of the 50 assessed disorders. Adjusted hazard ratios per 1-mg increase in aluminum exposure were 0.98 (95% CI, 0.94 to 1.02) for any autoimmune disorder, 0.99 (95% CI, 0.98 to 1.01) for any atopic or allergic disorder, and 0.93 (95% CI, 0.90 to 0.97) for any neurodevelopmental disorder. For most individually analyzed outcomes, upper bounds of 95% CIs were incompatible with relative increases greater than 10% or 30%.

Why it matters

This study provides large-scale population evidence addressing safety concerns about aluminum adjuvants, showing no link between early childhood vaccine aluminum exposure and major chronic autoimmune, allergic, or neurodevelopmental conditions.

Limits

Individual medical records were not reviewed to validate diagnostic registry codes. In addition, small relative effects could not be statistically excluded for some rarer disorders, and residual confounding from observational registry data remains possible.

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