Pertussis vaccination and wheezing illnesses in young children: prospective cohort study

Henderson, John; North, Kate; Griffiths, Mancell; Harvey, I. C.; Golding, Jean

doi:10.1136/bmj.318.7192.1173

Cited by 87 publications

(60 citation statements)

References 14 publications

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“…Several studies found an increased risk of asthma and allergy in DTP or pertussis-vaccinated children [1][2][3][4], but this may be due to residual confounding or confounding by indication as the reasons for not vaccinating are not described and may be related to the outcome. A number of studies found no relation between the DTP or the pertussis-vaccination and atopy [5][6][7][8][9]. One of these is a randomised controlled trial [8], which compared three groups that received different cocktails of DTP with a control group that received DT only.…”

Section: Discussionmentioning

confidence: 99%

“…A minority of these 700 families refused vaccinations for religious reasons. The relation between pertussis-vaccination status and atopic disorders was analysed by means of adjusted logistic regression for repeated measurements in order to account for the correlation between sibship members.The 700 An increased risk of atopic disorders in pertussis or diphtheria tetanus pertussis (DTP) vaccinated children has been reported [1-4], but this was not confirmed by more recent observational studies [5][6][7], a randomised placebocontrolled trial [8], and an ecological study [9]. Reports of adverse effects of vaccinations usually cause controversy and debate between advocates and opponents of vaccination programmes.…”

mentioning

confidence: 99%

“…An increased risk of atopic disorders in pertussis or diphtheria tetanus pertussis (DTP) vaccinated children has been reported [1][2][3][4], but this was not confirmed by more recent observational studies [5][6][7], a randomised placebocontrolled trial [8], and an ecological study [9]. Reports of adverse effects of vaccinations usually cause controversy and debate between advocates and opponents of vaccination programmes.…”

mentioning

confidence: 99%

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Lower risk of atopic disorders in whole cell pertussis-vaccinated children

Bernsen¹,

Jongste²,

Wouden³

2003

European Respiratory Journal

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This study addressed whether whole cell pertussis-vaccinated children have a different risk of atopic disorders compared with children who did not receive this vaccination.Data on vaccination status, atopic disorders and child and family characteristics of the children of 700 families were collected in this retrospective study. A minority of these 700 families refused vaccinations for religious reasons. The relation between pertussis-vaccination status and atopic disorders was analysed by means of adjusted logistic regression for repeated measurements in order to account for the correlation between sibship members.The 700 An increased risk of atopic disorders in pertussis or diphtheria tetanus pertussis (DTP) vaccinated children has been reported [1-4], but this was not confirmed by more recent observational studies [5][6][7], a randomised placebocontrolled trial [8], and an ecological study [9]. Reports of adverse effects of vaccinations usually cause controversy and debate between advocates and opponents of vaccination programmes. The current study evaluated the role of the pertussis vaccination as a risk factor for atopic disorders within a study of family size and birth order as risk factors for asthma, allergy and eczema in a population of 700 families in the Netherlands. Material and methods Study subjectsIn a study in the Netherlands designed to determine the role of sibship size and birth order as risk factors for asthma, allergy and eczema 700 families with index children born in 1988, 1989 or 1990 were sampled from files administered by the Municipal Health Service covering the municipality of Zwijndrecht, a town with w40,000 inhabitants. A subgroup of these families adhere to the orthodox reformed religion and their children mostly attend orthodox reformed schools. Some of the parents of this group refrain from vaccinations for religious reasons. According to an official schedule in the Netherlands, children receive four vaccinations of DTP (whole cell), Poliomyelitis and Haemophilus influenzae type B at aged v1 yr (before 1998 at aged 3, 4, 5 and 11 months), mumps-measles-rubella (MMR) at aged 14 months, a booster of DT-Poliomyelitis at aged 4 and 9 yrs and a booster of MMR at aged 9 yrs. Since 2002 a booster of acellular pertussis is administered at aged 4 yrs. Study designThis was a retrospective study using datafiles from routine health checkups from birth till adolescence. MethodsData on preventive health checkups of index children aged 6 yrs performed by the Municipal Health Service were collected from the files. Data from files of their siblings were also extracted. The following data were used: presence and type of allergy, asthma, eczema, current medication, birth order, sibship size, date of birth, sex, date of checkup, year of birth of the mother, postal code, country of birth of the parents, occupation of the breadwinner, atopic disorders of the parents, vaccination status, and duration of breastfeeding. A child was considered having asthma, allergy or eczema if this was mention...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Lower risk of atopic disorders in whole cell pertussis-vaccinated children

Bernsen¹,

Jongste²,

Wouden³

2003

European Respiratory Journal

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“…About half of the British 1970 birth cohort, w13,000 children, were vaccinated against measles and no substantial difference in the prevalence of hay fever or eczema was evident at the age of 5 yrs when immunized and nonimmunized subjects were compared [86]. Although, in theory, pertussis vaccine or its associated adjuvant may increase IgE production and thereby the risk of allergy, the results of several epidemiological studies have excluded a major increase in the risk of allergy [87,88]. Conversely, immunization with BCG, which may induce Th1 responses, has not been shown to confer protection from the development of allergy when administered once early in life [89,90].…”

Section: Role Of Vaccinations and Antibiotic Usementioning

confidence: 99%

Infection: friend or foe in the development of atopy and asthma?

Mutius¹

2001

European Respiratory Journal

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There is increasing evidence from epidemiological studies to support the "hygiene hypothesis" with regard to the development of allergic diseases. This review will discuss the epidemiological findings relating to atopy and asthma, separately.The strongest arguments in favour of the "hygiene hypothesis" are the findings relating early life day care attendance to a significantly reduced risk of atopy and asthma, and the strong link between sibship size and the occurrence of atopy as confirmed by numerous studies.Furthermore, data relating serological immune responses to certain infections such as hepatitis A and Toxoplasma gondii suggest a role for such infections, or alternatively the lack of hygiene, to be operative in the inhibition of the development of allergic immune responses. The effects described seem to be stronger for atopy than for asthma.Furthermore, biological plausibility for such a hypothesis can be found from findings of recent in vitro studies and from animal experiments. Epidemiological studies attempting to identify single infections as being harmful or beneficial could fail, because it may be the total burden of microbial stimuli rather than a certain infection that directs the maturing immune system into a Th1-type T-helper cell polarized response. The timing of the exposure seems to be essential for promoting beneficial or harmful effects, and may provide a "window of opportunity".

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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.…”

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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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Pertussis vaccination and wheezing illnesses in young children: prospective cohort study

Abstract: Objectives To examine the relation between pertussis vaccination and the prevalence of wheezing illnesses in young children. Design Prospective cohort study. Setting Three former health districts comprising Avon Health Authority.

Cited by 87 publications

References 14 publications

Lower risk of atopic disorders in whole cell pertussis-vaccinated children

Lower risk of atopic disorders in whole cell pertussis-vaccinated children

Infection: friend or foe in the development of atopy and asthma?

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

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