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1248827 
Journal Article 
Serum vaccine antibody concentrations in children exposed to perfluorinated compounds 
Grandjean, P; Andersen, EW; Budtz-Jørgensen, E; Nielsen, F; Mølbak, K; Weihe, P; Heilmann, C 
2012 
Yes 
JAMA: Journal of the American Medical Association
ISSN: 0098-7484
EISSN: 1538-3598 
307 
391-397 
English 
has erratum 5387131 (vol 307, pg 391, 2012)
CONTEXT: Perfluorinated compounds (PFCs) have emerged as important food contaminants. They cause immune suppression in a rodent model at serum concentrations similar to those occurring in the US population, but adverse health effects of PFC exposure are poorly understood.

OBJECTIVE: To determine whether PFC exposure is associated with antibody response to childhood vaccinations.

DESIGN, SETTING, AND PARTICIPANTS: Prospective study of a birth cohort from the National Hospital in the Faroe Islands. A total of 656 consecutive singleton births were recruited during 1997-2000, [corrected] and 587 participated in follow-up through 2008.

MAIN OUTCOME MEASURES: Serum antibody concentrations against tetanus and diphtheria toxoids at ages 5 and 7 years.

RESULTS: Similar to results of prior studies in the United States, the PFCs with the highest serum concentrations were perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid (PFOA). Among PFCs in maternal pregnancy serum, PFOS showed the strongest negative correlations with antibody concentrations at age 5 years, for which a 2-fold greater concentration of exposure was associated with a difference of -39% (95% CI, -55% to -17%) in the diphtheria antibody concentration. PFCs in the child's serum at age 5 years showed uniformly negative associations with antibody levels, especially at age 7 years, except that the tetanus antibody level following PFOS exposure was not statistically significant. In a structural equation model, a 2-fold greater concentration of major PFCs in child serum was associated with a difference of -49% (95% CI, -67% to -23%) in the overall antibody concentration. A 2-fold increase in PFOS and PFOA concentrations at age 5 years was associated with odds ratios between 2.38 (95% CI, 0.89 to 6.35) and 4.20 (95% CI, 1.54 to 11.44) for falling below a clinically protective level of 0.1 IU/mL for tetanus and diphtheria antibodies at age 7 years.

CONCLUSION: Elevated exposures to PFCs were associated with reduced humoral immune response to routine childhood immunizations in children aged 5 and 7 years. 
• PCBs
     Excluded
     Litsearches
          Remaining
          LitSearch August 2015
               Pubmed
               Toxline
PFAS
• Additional PFAS (formerly XAgency)
     Literature Search November 2019
          Other Sources
               ATSDR
               Reference list review of included studies
               TEDX
     Screened Studies
          Included
               Include (TIAB)
          Excluded
               Exclude (Full Text)
• Expanded PFAS SEM (formerly PFAS 430)
     Litsearch: September 2019
          PubMed
          Web of Science
          Other Sources
               PFAS TOX Database
     Screened Studies
          Included
               Include (TIAB)
          Excluded
               Exclude (Full Text)
     Not prioritized for screening
     Perfluorooctane
• PFAS 150
     Literature Search Update December 2020
          PubMed
          WOS
     Literature Search August 2019
          PubMed
          Web of Science
          Other sources
               Reference list review of included studies
               PFAS TOX Database
     Screened Studies
          Included
               Include (TIAB)
          Excluded
               Exclude (Full Text)
     Ammonium perfluorooctanoate
     Perfluorinated compounds
     Perfluorooctane
     Perfluorooctanesulfonic acid
     Perfluorooctanoic acid
• PFDA
     Literature Search
          Pubmed
     Scopus: April 2021
     Title and Abstract Screening
          Full Text Screening
               Studies Meeting PECO
                    Human health effect studies
     June 2022 Pelch Database
     Submitted to EPA
     Literature Searches (through April 2023 update and post-public comment/peer review)a    
          Other
               Published PFAS SEMs
          Title & Abstract Screening
               Tagged as Supplemental
                    Full Text Screening
                         Studies Meeting PECO
                              Human health effects studies
• PFHxS
     Database searches
          Pubmed
          Toxline
          WOS
          Scopus
          Pelch PFAS SEM
          Other
     Inclusion
          TiAb
          Full Text
               Human Study
• PFNA
     Literature Search
          Additional Strategies
          ATSDR
     Title and Abstract Screening
          Full Text Screening
               Studies Meeting PECO
                    Human health effects studies
     June 2022 Pelch Database
• PFOA and PFOS OW MCLG Approaches
     Cited in White Papers