Extensive Swelling After Booster Doses of Acellular Pertussis–Tetanus–Diphtheria Vaccines

Rennels, Margaret B.; Deloria, Maria A.; Pichichero, Michael E.; Losonsky, Genevieve A.; Englund, Janet A.; Meade, Bruce D.; Anderson, Edwin L.; Steinhoff, Mark C.; Edwards, Kathryn M.

doi:10.1542/peds.105.1.e12

Cited by 140 publications

(55 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…23 Moreover, in our opinion, it is unlikely that the variability in the content and purity of preservatives and adjuvants across different vaccines accounts for an important part of the differences observed in the occurrence of local reactions.…”

Section: Discussionmentioning

confidence: 82%

“…Although the sample size of DT recipients was too small for detecting formal statistical differences for such infrequent events (only 1 extensive local reaction was observed in this group), this result is consistent with that obtained from a recent study performed on children who received a fifth dose of DTaP vaccine. 23 An additional finding was that ϳ20% of the DTaP booster recipients and 5% of the DT recipients experienced local itching after booster administration. The higher occurrence of extensive local reactions and local itching among DTaP booster recipients suggests that these reactions may have an immunologic component linked to the pertussis antigens included in DTaP vaccines.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Reactogenicity and Immunogenicity at Preschool Age of a Booster Dose of Two Three-Component Diphtheria-Tetanus-Acellular Pertussis Vaccines in Children Primed in Infancy With Acellular Vaccines

Tozzi

Anemona²,

Stat

et al. 2001

Pediatrics

View full text Add to dashboard Cite

ABSTRACT. Objectives. To determine the reactogenicity and immunogenicity of a fourth dose of 2 threecomponent acellular pertussis vaccines combined with diphtheria-tetanus-acellular pertussis (DTaP) when administered at preschool age to children primed in infancy with 3 doses of the same DTaP and who had received a diphtheria-tetanus (DT) dose at the age of 12 months.Setting. Local health units of 4 Italian regions. Study Design. Three thousand five hundred twentytwo children, who had been randomized in the first year of life to be immunized with a DTaP vaccine by either SmithKline Beecham or Chiron Biocine, were offered a booster of the same vaccine or, if refusing, a DT vaccine at the age of 5 to 6 years. Families of children were aware of the vaccine administered. The occurrence of adverse events was compared between the children who received a DTaP booster and those boosted with a DT only. Antibody titers to pertussis vaccine components (pertussis toxin, filamentous hemoagglutinin, and pertactin) were determined on 558 paired sera taken before and 30 days after the DTaP booster administration.Results. Four episodes of temperature >39.5°C, 2 in each DTaP group, were recorded. Fever >38°C occurred infrequently in both DTaP and DT recipients (DTaP range: 2.5%-2.8%; DT range: 0%-4.8%), as did irritability (DTaP range: 10.1%-11.7%; DT range: 7.4%-12.6%). The frequency of local reactions was significantly higher for DTaP recipients (range: 44.0%-52.8%), with respect to DT recipients (range: 29.5%-44.4%). Extensive local reactions were observed in 1.2% of DTaP recipients and in .5% of DT recipients. Both DTaP vaccines induced high antibody titers against pertussis toxin, filamentous hemoagglutinin, and pertactin, with an increase of >10 times the prebooster geometric mean titers.Conclusions. A booster dose of DTaP at preschool age in children primed with the same acellular pertussis vaccine is safe and immunogenic. However, the frequency of local reactions is higher compared with that following primary immunization and with that following booster with DT only, and parents should be informed of the potential for these reactions to occur. Pediatrics 2001; 107(2). URL: http://www.pediatrics.org/cgi/content/full/ 107/2/e25; pertussis vaccine, adverse effects, immunoresponse, booster dose, children.ABBREVIATIONS. DTaP, diphtheria-tetanus-acellular pertussis; DT, diphtheria-tetanus; SB, SmithKline Beecham; CB, Chiron Biocine; PT, pertussis toxin; FHA, filamentous hemoagglutinin; PRN, pertactin; IgG, immunoglobulin G; ELISA, enzyme-linked immunosorbent assay; EU, ELISA units; MLD, minimal level of detection; PT CHO, antibodies neutralizing pertussis toxin on Chinese hamster ovary cells; GMT, geometric mean titer; RR, relative risk; CI, confidence interval. R ecent studies, including clinical trials, have demonstrated that acellular pertussis vaccines are efficacious and have a lower reactogenicity than whole-cell vaccines. [1][2][3][4][5] These findings have led various countries to use acellular vaccines for primary immu...

show abstract

Section: Discussionmentioning

confidence: 82%

mentioning

confidence: 99%

Reactogenicity and Immunogenicity at Preschool Age of a Booster Dose of Two Three-Component Diphtheria-Tetanus-Acellular Pertussis Vaccines in Children Primed in Infancy With Acellular Vaccines

Tozzi

Anemona²,

Stat

et al. 2001

Pediatrics

View full text Add to dashboard Cite

show abstract

“…In the NIAID study, it was noted that 20 children had entire thigh swelling in the leg where the fourth dose of a DTaP vaccine was injected (656). This reaction was noted to have a significant linear association with the amount of diphtheria toxoid in the DTaP vaccine, and it was not observed after receipt of either ACEL-IMMUNE or Tripedia, the two vaccines with the smaller amounts of diphtheria toxoid.…”

Section: B Pertussis Vaccinesmentioning

confidence: 99%

“…In general, good DTP vaccines contained more antigens than the present DTaP vaccines but the concentrations of the antigens in the DTP vaccines were modest. In contrast, the specific antigens (PT, FHA, PRN, and FIM) in DTaP vaccines are present in higher concentrations than their counterparts in (656). In addition, one of the two vaccines has a large amount of PT, which contributes to local reactions with booster doses (759b).…”

Section: Infant and Childhood Dtap Immunization Schedulesmentioning

confidence: 99%

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

2005

View full text Add to dashboard Cite

Bordetella respiratory infections are common in people (B. pertussis) and in animals (B. bronchiseptica). During the last two decades, much has been learned about the virulence determinants, pathogenesis, and immunity of Bordetella. Clinically, the full spectrum of disease due to B. pertussis infection is now understood, and infections in adolescents and adults are recognized as the reservoir for cyclic outbreaks of disease. DTaP vaccines, which are less reactogenic than DTP vaccines, are now in general use in many developed countries, and it is expected that the expansion of their use to adolescents and adults will have a significant impact on reducing pertussis and perhaps decrease the circulation of B. pertussis. Future studies should seek to determine the cause of the unique cough which is associated with Bordetella respiratory infections. It is also hoped that data gathered from molecular Bordetella research will lead to a new generation of DTaP vaccines which provide greater efficacy than is provided by today's vaccines

show abstract

“…Local reactions are generally of moderate entity but can be signiicant at times, making parents and patients antonyms to revaccination. Local reactions are commonly observed following tetanus, pertussis, and diphtheria vaccine: reports demonstrated that the rate and severity increase with booster compared with primary doses of these antigens [20][21][22][23][24][25].…”

Section: Kinds Of Vaesmentioning

confidence: 99%

Adverse Events Related to Vaccination (VAEs): How to Manage the Further Doses of Immunization and Parents’ Hesitancy

Gattinara¹,

Bellelli²,

Angelone³

et al. 2017

Vaccines

View full text Add to dashboard Cite

This study supports the evidence that after vaccine-related reactions, it is still possible to carry out the immunization protocol.Out of more than 1000 patients per year evaluated for potential vaccine-related risks (patients with chronic/serious diseases and events connected with vaccination), 76 (6%) presented previous vaccine adverse events (VAEs). The decision about whether to continue child vaccination is made evaluating diferent factors: absence of speciic contraindications, parents' counseling, adequate hospital seting, choice of an appropriate and individualized schedule. None of the 76 children vaccinated after VAEs presented further side efects.Our data demonstrate that VAE is not a recurring event. The real risk of a new VAE is mostly associated with the serious allergic reactions (IgE-mediated anaphylaxis) and parents should be aware of this information, so that the widespread fear of VAE recurrence can be contained. Indeed, this type of concerns represents one of the main reasons for vaccination hesitancy, which leads to incomplete vaccination schedules.Conclusions: This chapter encourages clinicians to take advantage of the available VAE assessment algorithms to objectively evaluate real vaccine risk of VAE and provide parents with correct information, considering that VAEs are rare and severe reactions are extremely rare.

show abstract

Extensive Swelling After Booster Doses of Acellular Pertussis–Tetanus–Diphtheria Vaccines

Abstract: Booster doses of DTaP vaccines can cause entire limb swelling, which is usually associated with redness and pain. Our data suggest that this extensive swelling reaction may be more common with vaccines containing high diphtheria toxoid content.

Cited by 140 publications

References 21 publications

Reactogenicity and Immunogenicity at Preschool Age of a Booster Dose of Two Three-Component Diphtheria-Tetanus-Acellular Pertussis Vaccines in Children Primed in Infancy With Acellular Vaccines

Reactogenicity and Immunogenicity at Preschool Age of a Booster Dose of Two Three-Component Diphtheria-Tetanus-Acellular Pertussis Vaccines in Children Primed in Infancy With Acellular Vaccines

Molecular Pathogenesis, Epidemiology, and Clinical Manifestations of Respiratory Infections Due toBordetella pertussisand OtherBordetellaSubspecies

Adverse Events Related to Vaccination (VAEs): How to Manage the Further Doses of Immunization and Parents’ Hesitancy

Contact Info

Product

Resources

About