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October 22/29, 2003

Safety of the Smallpox Vaccine Among Military Recipients—Reply

Author Affiliations

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;290(16):2124-2126. doi:10.1001/jama.290.16.2124-a

In Reply: Drs Malloy and Freeman dispute our premise that "deaths occurring on a particular day of the week spring from the cohort of births for that day of the week" and suggest that the risk of death is randomly distributed across the week. Because birth weight is a major risk factor for neonatal mortality, however, using a linked birth/death cohort file, our finding that the decrease in weekend deliveries was least pronounced in smaller infants strongly supports the notion that the risk of mortality is not randomly distributed across the week. We also disagree with their assertion that neonatal death "is a random event not necessarily related to the day of birth."