Science Library Category:

DTaP/Tdap

Published: 2019
SYNOPSIS

Out-of-sequence vaccinations may increase child mortality.

TITLE

Out-of-sequence DTP and measles vaccinations and child mortality in Guinea-Bissau: a reanalysis.

CITATION

Thysen SM, Rodrigues A, Aaby P, et al.  British Medical Journal Open 2019;9:e024893; doi:10.1136/bmjopen-2018-024893.

SUMMARY

This study’s objective was to assess whether the sequence of diphtheria-tetanus-pertussis vaccine (DTP) and measles vaccine (MV) was associated with child survival. Using a data set previously used to assess non-specific effects of vaccines with no consideration of vaccination sequence researchers found that out-of-sequence vaccinations in children were associated with higher mortality compared with children vaccinated in-sequence.

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Published: 2016
SYNOPSIS

In seven studies of BCG-vaccinated children, DTP vaccination was associated with a 2.54 (95% Cl 1.68- 3.86) increase in mortality in girls (with no increase in boys [ratio 0.96, 0.55-1.68]). The ways in which the female and the male immune systems may respond differently to vaccinations in infants are only beginning to be studied.

TITLE

Is diphtheria-tetanus-pertussis (DTP) associated with increased female mortality? A meta-analysis testing the hypotheses of sex-differential non-specific effects of DTP vaccine.

CITATION

Peter Aaby, Henrik Ravn, Ane B. Fisker, Amabelia Rodrigues, and Christine S. Benn; Transactions of the Royal Society of Tropical Medicine and Hygiene. 2016 Dec; 110(10): 570–581.doi: 10.1093/trstmh/trw073.

SUMMARY

Ten years ago, we formulated two hypotheses about whole-cell diphtheria-tetanus-pertussis (DTP) vaccination: first, when given after BCG (bacille Calmette-Guerin, is a vaccine for tuberculosis), DTP increases mortality in girls and, second, following DTP there is an increase in the female/male mortality rate ratio (MRR). A recent review by WHO found no convincing evidence that DTP increases mortality in females. Now, ten years later, we have tested the two hypotheses using studies from before, but also those published since formulation of the hypotheses. All studies published after the formulation of the hypotheses of the association of DTP with increased mortality.

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Published: 2014
SYNOPSIS

These data provide a plausible explanation for pertussis resurgence and suggest that attaining herd immunity will require the development of improved vaccination strategies that prevent B. pertussis colonization and transmission.

TITLE

Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate model

CITATION

Jason M. Warfel, Lindsey I. Zimmerman, and Tod J. Merkel; Proceedings of the National Academy of Sciences; January 14, 2014, 111 (2), 787-792; https://doi.org/10.1073/pnas.1314688110.

SUMMARY

In this study, researchers found that current acellular pertussis (aP) vaccines fail to prevent colonization and transmission. Nonhuman primates vaccinated with current acellular Pertussis (aP) were protected from severe symptoms but not infection and readily transmitted Bordetella pertussis to contacts.

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Published: 2012
SYNOPSIS

Surprisingly, even though the children with the best nutritional status were vaccinated early, early DTP vaccination was associated with increased mortality.

TITLE

Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children: an observational study within a randomised trial.

CITATION

Aaby P, Ravn H, Roth A, Rodrigues A, Lisse IM, Diness BR, Lausch KR, Lund N, Rasmussen J, Biering-Sorensen S, Whittle H, Benn CS. Archives of Disease in Childhood. 2012 Aug;97(8):685-91. doi: 10.1136/archdischild-2011-300646. Epub 2012 Feb 13.

SUMMARY

Studies from low-income countries have suggested that diphtheria-tetanus-pertussis (DTP) vaccine provided after Bacille Calmette-Guerin (BCG) vaccination may have a negative effect on female survival. The authors examined the effect of DTP in a cohort of low birthweight (LBW) infants and found, surprisingly, even though the children with the best nutritional status were vaccinated early, early DTP vaccination was associated with increased mortality for girls.

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Published: 2010
SYNOPSIS

Acellular Pertussis vaccination interferes with the optimal clearance of B. parapertussis and enhances the performance of this pathogen. Our data raise the possibility that widespread acellular Pertussis vaccination can create hosts more susceptible to B. parapertussis infection.

TITLE

Acellular pertussis vaccination facilitates Bordetella parapertussis infection in a rodent model of bordetellosis

CITATION

Gráinne H. Long, Alexia T. Karanikas, Eric T. Harvill, Andrew F. Read and Peter J. Hudson, Proceedings of the Royal Society B, Biological Sciences; 03 March, 2010; Volume 277; https://doi.org/10.1098/rspb.2010.0010

SUMMARY

Despite over 50 years of population-wide vaccination, whooping cough incidence is on the rise. Although Bordetella pertussis is considered the main causative agent of whooping cough in humans, Bordetella parapertussis infections are not uncommon. The widely used acellular whooping cough vaccines (aP) are comprised solely of B. pertussis antigens that hold little or no efficacy against B. parapertussis. Here, we ask how aP vaccination affects competitive interactions between Bordetella species within co-infected rodent hosts and thus the aP-driven strength and direction of in-host selection. We show that aP vaccination helped clear B. pertussis but resulted in an approximately 40-fold increase in B. parapertussis lung colony-forming units (CFUs). Such vaccine-mediated facilitation of B. parapertussis did not arise as a result of competitive release; B. parapertussis CFUs were higher in aP-relative to sham-vaccinated hosts regardless of whether infections were single or mixed. Further, we show that aP vaccination impedes host immunity against B. parapertussis—measured as reduced lung inflammatory and neutrophil responses. Thus, we conclude that aP vaccination interferes with the optimal clearance of B. parapertussis and enhances the performance of this pathogen. Our data raise the possibility that widespread aP vaccination can create hosts more susceptible to B. parapertussis infection.

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Published: 2008
SYNOPSIS

Children who delayed the timing of the DPT vaccine had lower rates of asthma.

TITLE

Delay in diphtheria, pertussis, tetanus vaccination is associated with a reduced risk of childhood asthma?

CITATION

McDonald KL, Huq SI. Journal of the American Academy of Allergy, Asthma and Immunology. 2008;121:626-631.

SUMMARY

“Early childhood immunizations have been viewed as promoters of asthma development by stimulating a T(H)2-type immune response or decreasing microbial pressure, which shifts the balance between T(H)1 and T(H)2 immunity. Among 11, 531 children who received at least 4 doses of DPT, the risk of asthma was reduced to (1/2) in children whose first dose of DPT was delayed by more than 2 months.”

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Published: 2005
SYNOPSIS

Among girls, those who received both BCG and DTP experienced higher mortality than those who received only one of the two vaccines (hazards ratio 2.4; 95% confidence interval 1.2-5.0).

TITLE

Evaluation of non-specific effects of infant immunization on early infant mortality in southern Indian population.

CITATION

Moulton LH, Rahmathullah L, Halsey NA, Thulasiraj RD, Katz J, Tielsch JM. Tropical Medicine and International Health, 2005 Oct;10(10):947-55.

SUMMARY

In a study of children under 2 years of age in Guinea-Bissau, Kristensen et al. (2000) found immunization with Bacille Calmette Guerin (BCG) vaccine to be associated with lower mortality, but stated that oral polio vaccine (OPV) and diphtheria, tetanus, polio (DTP) vaccines were associated with higher mortality. More recently, it has been suggested that this effect may be gender-specific, existing primarily among girls. This evaluation, focused on relating timing of BCG and DTP vaccine receipt to mortality from 1 week to 6 months of age, with emphasis on gender differentials found that girls that received both BCG and DTP experienced higher mortality than those who received only one of the two vaccines.

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Published: 2004
SYNOPSIS

The MR (mortality rate) was 1.81 (95% Cl: 0.95, 3.45) for the first dose of DTP and 4.36 (95% Cl: 1.28, 14.9) for the second and third dose

TITLE

The introduction of diphtheria-tetanus-pertussis vaccine and child mortality in rural Guinea­Bissau: an observational study.

CITATION

Aaby P, Jensen H, Gomes J, Fernandes M, Lisse IM. International Journal of Epidemiology. 2004 Apr;33(2):374-80.

SUMMARY

Prior to the introduction of vaccines, children who were absent at a village examination had the same mortality as children who were present. During 1984-1987, children receiving DTP at 2-8 months of age had higher mortality over the next 6 months, the mortality rate ratio (MR) being 1.92 (95% CI: 1.04, 3.52) compared with DTP-unvaccinated children, adjusting for age, sex, season, period, BCG, and region. The MR was 1.81 (95% CI: 0.95, 3.45) for the first dose of DTP and 4.36 (95% CI: 1.28, 14.9) for the second and third dose. BCG was associated with slightly lower mortality (MR = 0.63, 95% CI: 0.30, 1.33), the MR for DTP and BCG being significantly inversed. Researchers found in low-income countries with high mortality, DTP as the last vaccine received may be associated with slightly increased mortality. Since the pattern was inversed for BCG, the effect is unlikely to be due to higher-risk children having received vaccination. The role of DTP in high mortality areas needs to be clarified.

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Published: 2000
SYNOPSIS

One dose of diphtheria, tetanus, and pertussis vaccine was associated with a mortality ratio of 1.84 (1.10 to 3.10) and two to three doses with a ratio of 1.38 (0.73 to 2.61) compared with children who had received no dose of these vaccines.”

TITLE

Routine vaccinations and child survival: follow up study in Guinea Bissau, West Africa.

CITATION

Kristensen I, Aaby P, Jensen H. British Medical Journal. 2000 Dec 9;321(7274):1435-8.

SUMMARY

Research on vaccines in developing countries recommended by the World Health Organization has emphasised serological responses and protection against specific diseases. The aim of the research has been to optimise vaccine schedules for control, elimination, or eradication of disease. In modelling exercises, vaccination against diphtheria, pertussis, tetanus, and polio has been assumed to save 1.5­2.0% of the children in areas with high infant mortality. However, these assumptions are not supported by data. Mortality was lower in the group vaccinated with any vaccine compared with those not vaccinated, however, recipients of one dose of diphtheria, tetanus, and pertussis or polio vaccines had higher mortality than children who had received none of these vaccines.

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Published: 2000
SYNOPSIS

UCLA researchers find the DTP vaccine is causing asthma.

TITLE

Effects of Diphtheria-Tetanus-Pertussis or Tetanus Vaccination on Allergies and Allergy-Related Respiratory Symptoms Among Children and Adolescents in the United States

CITATION

Eric L. Hurwitz, DC, PhD, and Hal Morgenstern, PhD. Journal of Manipulative and Physiological Therapeutics, Volume 23, Number 2, February 2000.

SUMMARY

“Asthma and other allergic hypersensitivity reactions and related symptoms may be caused, in part, by the delayed effects of DTP or tetanus vaccination. Because the proportion of US children who have received at least 1 dose of DTP vaccine approaches 100%, the number of allergies and allergy-related conditions attributable to DTP or tetanus vaccination in the United States may be very high. For example, assuming that the estimated vaccination effect is unbiased, 50% of diagnosed asthma cases (2.93 million) in US children and adolescents would be prevented if the DTP or tetanus vaccination was not administered.”

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Published: 1997
SYNOPSIS

Addition of the Hepatitis B Vaccine in 1988 Increased the Rate of Type 1 Diabetes 1.62X in Children in New Zealand. The incidence of type I diabetes in person 0-19 years old living in Christchurch rose from 11.2 cases per 100,000 children annually in the years before the immunization program, 1982-1987, to 18.1 cases per 100,000 children annually ( P = .0008) in the years following the immunization, 1989-1991.

TITLE

The timing of pediatric immunizations and the risk of Insulin-Dependent diabetes mellitus

CITATION

Classen David C.; Classen, John Barthelow; Infectious Diseases in Clinical Practice: September-October 1997 – Volume 6 – Issue 7 – ppg 449-454.

SUMMARY

Insulin-dependent diabetes mellitus (IDDM) is believed to be an autoimmune disease induced by a variety of environmental stimuli. Vaccines and infectious agents have been suggested to have an influence, but most of this research has been centered on the ability of these agents to infect the pancreatic islet cells or contain antigens that mimic autoantigens. Classen found that administration of the diphtheria-tetanus-pertussis (DTP) and anthrax vaccines to mice and rats at birth prevented the development of diabetes, whereas administration of the DTP vaccine starting at 8 weeks was associated with an increased incidence of diabetes.

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