No Increased Risk For Invasive Bacterial Infection Found Following Diphtheria-Tetanus-Pertussis Immunization
Abstract
During the acellular pertussis vaccine trial in Sweden, 4 children who were randomly assigned to receive the vaccine died of suspected or confirmed bacterial infections compared to 1 expected. There were no deaths in the placebo arm. This raised concern about the role of pertussis immunization in the development of serious infections. Through linking computerized immunization records with an active surveillance system for serious bacterial infections in children, the authors studied a cohort of 64 591 children immunized through Tennessee county health clinics who had a total of 158 episodes of invasive bacterial infections after a diphtheria and tetanus toxoids and pertussis (DTP) immunization. There were 8 invasive bacterial infections that occurred within the first 7 days following DTP immunization,yielding an age-adjusted relative risk (95% confidence interval) of 1.0 (0.5 to 2.0), compared to the interval 29 or more days following immunization. There were 7 and 20 infections in the 8- through 14- and 15-through 28-day intervals following DTP immunization, giving relative risks of 0.8 (0.4 to 1.7) and 1.2 (0.7 to 1.9), respectively. These data provide reassurance that the use of DTP vaccine is not followed by a large increased risk of serious bacterial infections.
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Multiple studies have shown that children who received vaccinations had a similar, or even reduced, risk of unconnected infections in the following period.
“multiple studies have shown that children who received vaccinations had a similar, or even reduced, risk of unconnected infections in the following period92–95.”
From A guide to vaccinology: from basic principles to new developments (2021) · cites this paper as [94]
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A guide to vaccinology: from basic principles to new developments
Pollard, A. J., & Bijker, E. M. (2021) · Nature Reviews Immunology · doi:10.1038/s41577-020-00479-7 · Cited by 1,593 · see citing works
Piedra, P. A., Gaglani, M., Riggs, M. W., Herschler, G. B., Fewlass, C., Watts, M., Kozinetz, C. A., Hessel, C., & Glezen, W. P. (2005) · PEDIATRICS · doi:10.1542/peds.2004-2258 · Cited by 109 · see citing works
Lucero, M., Dulalia, V. E., Parreño, R. A. N., Lim-Quianzon, D., Nohynek, H., Mäkelä, H., & Williams, G. M. (2004) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004977 · Cited by 75 · see citing works
Gaglani, M., Piedra, P. A., Riggs, M. W., Herschler, G. B., Fewlass, C., & Glezen, W. P. (2008) · The Pediatric Infectious Disease Journal · doi:10.1097/inf.0b013e3181660c2e · Cited by 47 · see citing works
“This methodology has been used extensively in postmarketing safety assessment of childhood vaccines.(33,40,41) Controlling for age and seasonality helped reduce bias attributed to age-related risk and time-related risk during the vaccination period.”
MethodStowe, J., Andrews, N., Taylor, B., & Miller, E. (2009) · Vaccine · doi:10.1016/j.vaccine.2008.12.038 · Cited by 43 · see citing works
Childhood vaccination and nontargeted infectious disease hospitalization.
Hviid, A. (2005) · JAMA · doi:10.1001/jama.294.6.699 · Cited by 31 · see citing works
“However, the studies were small case-control studies(2-4) and a cohort study without an unvaccinated comparison group.(5) Furthermore, the majority of these studies only included the immediate postvaccination period.”
BackgroundResultDoes antigenic overload exist? The role of multiple immunizations in infants
Gregson, A. L., & Edelman, R. (2003) · Immunology and Allergy Clinics of North America · doi:10.1016/s0889-8561(03)00097-3 · Cited by 28 · see citing works
“Other studies have failed to show a positive correlation between childhood vaccinations and heterologic infections [77–79], whereas other studies have described a beneficial effect above and beyond the expected reduction in mortality from the targeted disease [80–83].”
ResultOtto, S., Mahner, B., Kadow, I., Beck, J. F., Wiersbitzky, S. K. W., & Bruns, R. (2000) · Journal of Infection · doi:10.1053/jinf.2000.0718 · Cited by 27 · see citing works
Whole-Cell and Acellular Pertussis Vaccines
Wintermeyer, S. M., Nahata, M. C., & Kyllonen, K. S. (1994) · Annals of Pharmacotherapy · doi:10.1177/106002809402800718 · Cited by 21 · see citing works
Safety of the trivalent, cold-adapted influenza vaccine (CAIV-T) in children
Piedra, P. A. (2002) · Seminars in Pediatric Infectious Diseases · doi:10.1053/spid.2002.122995 · Cited by 16 · see citing works
Decker, M. D., Edwards, K. M., & Howe, B. J. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-35761-6.00015-8 · Cited by 11 · see citing works
Safety and effectiveness of the trivalent, cold-adapted influenza vaccine (CAIV-T) in children
Piedra, P. A., Gaglani, M., Herschler, G. B., et al. (2001) · International Congress Series · doi:10.1016/s0531-5131(01)00019-x · Cited by 11 · see citing works
Decker, M. D., Edwards, K. M., & Bogaerts, H. H. (2013) · Elsevier eBooks · doi:10.1016/b978-1-4557-0090-5.00015-x · Cited by 7 · see citing works
Urinary Tract Diseases Revealed after DTP Vaccination in Infants and Young Children
PRANDOTA, J. (2004) · American Journal of Therapeutics · doi:10.1097/01.mjt.0000117501.97441.c92004 · Cited by 7 · see citing works
Miller, E., & Stowe, J. (2011) · Wiley eBooks · doi:10.1002/9780470975053.ch13 · Cited by 3 · see citing works
Bjarnarson, S. P., & Brynjolfsson, S. F. (2022) · Clinical & Experimental Immunology · doi:10.1093/cei/uxac113 · Cited by 2 · see citing works
Decker, M. D., Howe, B. J., Greenberg, D. P., & Edwards, K. M. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-79058-1.00016-5 · Cited by 1 · see citing works
- Authors
- Griffin, M. R., Taylor, J. A., Daugherty, J. R., & Ray, W. A.
- Affiliations
- Vanderbilt University (US)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 1992-04-01
- Volume
- 89
- Issue
- 4
- Pages
- 640-642
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W1532357488
- Cited by
- 17
- References
- 0
- Citations by year
- 2023: 1 · 2022: 1 · 2020: 1 · 2017: 1 · 2013: 1
- FWCI
- 0.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Food and Drug Administration (FD-U-0000073)
- U.S. Public Health Service (200-85-0874, 200-85-0862)
- Topics
- Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Diphtheria, Corynebacterium, and Tetanus
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- DTP vaccine, invasive bacterial infection, serious bacterial infection, acellular pertussis vaccine, vaccine safety, children, relative risk, immunization records, Tennessee
- MeSH terms
- Bacterial Infections, Child, Child, Preschool, Follow-Up Studies, Haemophilus Infections, Haemophilus influenzae, Humans, Infant, Pneumococcal Infections, Population Surveillance, Risk Factors, Tennessee, Time Factors, Vaccination, Cohort Studies, Diphtheria-Tetanus-Pertussis Vaccine, Incidence
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