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Longitudinal birth cohort of 18,468 children, including roughly 16,500 vaccinated children and nearly 2,000 completely unvaccinated children. Investigators used medical records and the Michigan immunization registry to verify vaccination status, then applied standard epidemiological methods including incidence-rate analyses, Cox proportional-hazards models, multivariable adjustment, Kaplan-Meier survival analysis, and multiple sensitivity analyses.
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