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July 20, 2001
U.S. IMMUNIZATION NEWS
“Acute Autoimmune Hemolytic Anemia Following DTP
Vaccination:
Report of a Fatal Case and Review of the Literature” Clinical
Pediatrics (06/01) Vol. 40, No. 6, P. 355; Downes, Katharine A.; Domen, Ronald
E.; McCarron, Karen F.
This study reviews the case of an African-American female
infant who experienced severe anemia and a drop in hemoglobin levels and was
admitted to the hospital in an unresponsive condition at just four months of age. Admitted to the hospital between her fifth and sixth week, the
infant exhibited unusual irritability and was tested for possible meningitis or
sepsis, and then was empirically treated with a combination of ceftaxime and ampicillin
and released in good health. At four
months of age, the child was given her second doses of the oral polio virus, hepatitis
B, and diphtheria, tetanus, and pertussis (DTP) vaccines, and within four days
she exhibited lethargy, a low level fever, and lack of appetite. She was unresponsive when admitted to the
hospital three days later, suffering from severe anemia and low hemoglobin
levels. Tests for Haemophilus influenza,
Streptococcus pneumoniae, and Neiseria meningitidis were negative or did not
appear conclusively as cause or contributor to the current condition. The infant continued to experience severe
hemolysis and died 41 hours after admission.
Although the study could not prove it conclusively, by eliminating other
causes of autoimmune hemolytic anemia (AIHA), the researchers suggest that, in
this case, there is “a causal relationship to the second DTP vaccination.” A 1992 report from the Institute of Medicine
concluded, however, that there is insufficient evidence of either the presence
or absence of such a connection.
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INFORMATION, DATA, AND MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR
GENERAL INFORMATION PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE
KNOWLEDGE OR OPINIONS OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED
AS PROVIDING MEDICAL OR LEGAL ADVICE. THE DECISION WHETHER OR NOT TO
VACCINATE IS AN IMPORTANT AND COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU
ALONE, IN CONSULTATION WITH YOUR HEALTH CARE PROVIDER.