A Randomized Controlled Trial of the Effect of Pertussis Vaccines on Atopic Disease

Nilsson, Lennart; Kjellman, N.‐I. M.; Björkstén, Bengt

doi:10.1001/archpedi.152.8.734

Cited by 128 publications

(84 citation statements)

References 26 publications

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“…[32][33][34][35][36][37][38][39] One well-controlled study was performed using the computerized records of children born between 1991 and 1997 who were enrolled in 4 large health maintenance organizations (HMOs). 32 This cohort was used to identify 18 407 children with asthma.…”

Section: Clinical Studies Evaluating the Relationship Between Vaccinementioning

confidence: 99%

“…33 Infants were randomized to receive 2-component diphtheriatetanus-acellular pertussis vaccine; 5-component diphtheria-tetanus-acellular pertussis, diphtheriatetanus-whole-cell pertussis; or diphtheria-tetanus (control group) beginning at 2 months of age. Children were followed for ϳ2.5 years and the risk of allergies was determined by parent questionnaires and examination of medical records.…”

Section: Clinical Studies Evaluating the Relationship Between Vaccinementioning

confidence: 99%

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Addressing Parents’ Concerns: Do Vaccines Cause Allergic or Autoimmune Diseases?

Offit

Hackett

2003

Pediatrics

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ABSTRACT. Anecdotal case reports and uncontrolled observational studies in the medical literature claim that vaccines cause chronic diseases such as asthma, multiple sclerosis, chronic arthritis, and diabetes. Several biological mechanisms have been proposed to explain how vaccines might cause allergic or autoimmune diseases. For example, allergic diseases might be caused by prevention of early childhood infections (the "hygiene hypothesis"), causing a prolongation of immunoglobulin E-promoting T-helper cell type 2-type responses. However, vaccines do not prevent most common childhood infections, and large well-controlled epidemiologic studies do not support the hypothesis that vaccines cause allergies. Autoimmune diseases might occur after immunization because proteins on microbial pathogens are similar to human proteins ("molecular mimicry") and could induce immune responses that damage human cells. However, wild-type viruses and bacteria are much better adapted to growth in humans than vaccines and much more likely to stimulate potentially damaging selfreactive lymphocytes. Consistent with critical differences between natural infection and immunization, well-controlled epidemiologic studies do not support the hypothesis that vaccines cause autoimmunity.Flaws in proposed biological mechanisms that explain how vaccines might cause chronic diseases are consistent with the findings of many well-controlled large epidemiologic studies that fail to show a causal relationship.

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Section: Clinical Studies Evaluating the Relationship Between Vaccinementioning

confidence: 99%

Section: Clinical Studies Evaluating the Relationship Between Vaccinementioning

confidence: 99%

Addressing Parents’ Concerns: Do Vaccines Cause Allergic or Autoimmune Diseases?

Offit

Hackett

2003

Pediatrics

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“…12 There are, however, few epidemiological studies that have examined the role of vaccinations in the development of atopy or asthma. 9,[13][14][15][16][17] For these reasons, we conducted a case-control study of asthma in childhood and report here the findings for demographic factors and vaccinations.…”

mentioning

confidence: 99%

A case‐control study of risk factors for asthma in New Zealand children

Wickens¹,

Crane²,

Kemp³

et al. 2001

Australian and New Zealand Journal of Public Health

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Objective : As in other English‐speaking countries, asthma is a major and increasing health problem in New Zealand. This study examined the risk factors for asthma in children aged 7–9. Methods : Cases and controls were randomly selected from participants in the Wellington arm of the International Study of Asthma and Allergies in Childhood (ISAAC). Cases were children with a previous diagnosis of asthma and current medication use (n=233), and controls were children with no history of wheezing and no diagnosis of asthma (n=241). Results : After controlling for confounders, factors significantly associated with asthma were maternal (OR=3.36, 95% Cl 1.88–5.99) and paternal asthma (OR=2.67, 95% Cl 1.42–5.02), and male sex (OR=1.81, 95% Cl 1.17–2.81). Children from social classes 5 and 6 or with unemployed parents (OR=2.32, 95% Cl 1.22–4.44) were significantly more likely to have asthma than children in social classes 1 and 2. There was no significant association between having polio vaccination (OR=2.48, 95% Cl 0.83–7.41), hepatitis B vaccination (OR=0.66, 95% Cl 0.42–1.04) or measles/mumps/rubella vaccination (OR=1.43, 95% Cl 0.85–2.41) and asthma. Conclusions : This study has confirmed the associations of family history and lower socio‐economic status with current asthma in 7–9 year old children. The role of vaccinations requires further research.

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“…By contrast, the widely used ACV vaccines also induce Th2-type cytokine (IL-4 and IL-5) responses to concomitant vaccine antigens in infants [60,62], becoming more pronounced when given closer to birth [63,64]. Although suggested earlier, current infant immunization with ACV does not seem to be a risk factor for the development of atopic disease in children [65,66], despite similarities in Th2 polarization of vaccine-induced and allergic T-cell responses. Recently, in a systems-level approach, it was demonstrated that the Th2 component of ACV-induced responses was counterbalanced by parallel Th2-antagonistic and antimicrobial immunity, which was either not present or actively downregulated within the Th2-polarized responses associated with allergic inflammation [67].…”

Section: Induction and Maintenance Of Pertussis Immunitymentioning

confidence: 98%