A randomized controlled trial of the effect of pertussis
vaccines on atopic disease.
Nilsson L, Kjellman NI, Bjorksten B.
Department of Health and Environment, Faculty of Health Sciences, University
Hospital, Linkoping, Sweden.
BACKGROUND: Pertussis vaccination in infancy has been suggested to increase the
risk for development of asthma and allergy. OBJECTIVE: To assess sensitization
rates and development of atopic diseases in a prospective randomized controlled
trial of pertussis vaccine. PATIENTS AND METHODS:
A total of 669 children were randomized
to 1 of 4 vaccine groups (2-component acellular pertussis, 5-component acellular
pertussis, whole-cell pertussis vaccines, and placebo [diphtheria and tetanus
toxoids]).
Diphtheria and tetanus toxoids were also given to the children in the pertussis
vaccine groups. The children were evaluated by means of questionnaires at age 2
months, 7 months, and 2 1/2 years; skin prick tests at age 7 months and 2 1/2
years; and blinded clinical investigation at age 2 1/2 years. The families were
contacted at regular intervals to assess possible adverse effects after the
vaccinations and symptoms of whooping cough. RESULTS: The cumulative incidence
of atopic diseases was 30% and incidence rates were similar in the 4 groups
after adjusting for family history. Exposure to environmental tobacco smoke and
home dampness did not confound these results. The frequency of adverse effects
did not differ appreciably between atopic and nonatopic children, with the
exception that a nodule at the vaccination site was more frequent after
whole-cell pertussis vaccination in the nonatopic children. Among 47 children
with proven pertussis, atopic disease appeared in 19 (40%). Of these 47
children, 9 (19%) developed asthma, as compared with 58 (9%) noninfected
children (P=.03). CONCLUSIONS: We found no support for a drastic increase in
allergic manifestations after pertussis vaccination. There was a positive
association between whooping cough and asthma by 2 1/2 years of age. There seems
to be little reason to withhold pertussis vaccination from infants, irrespective
of family history of allergy.
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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.
"A foolish faith in authority is the worst enemy of truth."
-- Albert Einstein, letter to a friend, 1901
"I know of no safe depository of the ultimate powers of the society but the people themselves, and if we think them not enlightened enough to exercise control with a wholesome discretion, the remedy is not to take it from them, but to inform their discretion by education."
-- Thomas Jefferson, letter to William C. Jarvis, September 28, 1820
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