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Absence of an increase in cardiorespiratory events after diphtheria-tetanus-acellular pertussis immunization in
Tracy Carbone1, Betty McEntire, Dmitry Kissin
1Center for Pediatric Sleep Disorders, Valley Hospital, 505 Goffle Rd, Ridgewood, NJ 07450, USA. tcarbon@valleyhealth.com
Insights
Diphtheria-tetanus-acellular pertussis (DTaP) immunization at 2 months chronological age is safe for preterm infants. This study found no increased risk of cardiorespiratory events like apnea or bradycardia in vaccinated preterm infants compared to controls.
Area of Science:
- Pediatrics
- Immunology
- Neonatology
Background:
- The American Academy of Pediatrics recommends DTaP immunization for preterm infants at 2 months chronological age.
- Concerns exist regarding potential cardiorespiratory events following immunization in preterm infants, leading to inconsistent adherence to guidelines.
- This study aimed to objectively assess the relationship between DTaP vaccination and cardiorespiratory events in this population.
Purpose of the Study:
- To reevaluate the association between diphtheria-tetanus-acellular pertussis (DTaP) vaccination and cardiorespiratory events in preterm infants.
- To utilize a randomized controlled study design with objective cardiorespiratory monitoring.
- To provide evidence-based data to support or refute current immunization recommendations for preterm infants.
Main Methods:
- A randomized controlled trial was conducted across ten hospitals involving 191 preterm infants (<37 weeks gestational age) at 56-60 days chronological age.
- Infants were randomly assigned to receive DTaP immunization (n=93) or serve as a control group (n=98).
- Continuous monitoring for 48 hours post-vaccination/assignment documented prolonged apnea and bradycardia, with statistical comparisons (chi-squared and t-tests) between groups.
Main Results:
- 16.1% of the DTaP group experienced prolonged apnea versus 20.4% in the control group.
- Prolonged bradycardia occurred in 58.1% of the DTaP group and 56.1% of the control group.
- No significant differences in the frequency or mean number of prolonged apnea (0.5 episodes in both groups) or bradycardia episodes (2.6 vs. 2.7) were observed between the immunized and control groups.
Conclusions:
- Preterm infants receiving DTaP immunization at 2 months chronological age are not at increased risk for prolonged apnea or bradycardia.
- The findings support the American Academy of Pediatrics' recommendation for timely DTaP immunization in preterm infants.
- Objective assessment confirms the safety profile of DTaP vaccination in this vulnerable population.
Objective:
The American Academy of Pediatrics recommends immunization of preterm infants at 2 months' chronological age with diphtheria-tetanus-acellular pertussis vaccine, regardless of birth weight and gestational age. Several investigators have reported an increased incidence of cardiorespiratory events in preterm infants after immunization. Consequently, many primary care providers do not adhere to American Academy of Pediatrics guidelines. The purpose of this study was to reexamine the relationship between diphtheria-tetanus-acellular pertussis and cardiorespiratory events in preterm infants by using a random control study design and an objective assessment of cardiorespiratory events.
Methods:
Ten hospitals enrolled 191 infants who were born at <37 weeks' gestational age at 56 to 60 days' chronological age. Infants were randomly assigned to a group that received diphtheria-tetanus-acellular pertussis immunization (n = 93) or a control group that did not (n = 98). Recording monitors were used continuously during the next 48 hours to document prolonged apnea and prolonged bradycardia. The presence and number of episodes during the 48-hour period were compared between groups by using chi(2) and t tests.
Results:
In the diphtheria-tetanus-acellular pertussis group, 16.1% experienced at least 1 episode of prolonged apnea compared with 20.4% of control infants. One or more prolonged bradycardia events occurred in 58.1% of immunized infants and 56.1% of the control infants. The frequency of episodes was not significantly different between groups. The immunization group and the control group each had an average of 0.5 episodes of prolonged apnea. The mean number of prolonged bradycardia episodes was 2.6 in the immunization group and 2.7 in the control group.
Conclusions:
Preterm infants who received diphtheria-tetanus-acellular pertussis at 2 months after birth were no more likely to experience prolonged apnea and bradycardia than were control infants. This study supports the American Academy of Pediatrics recommendation regarding diphtheria-tetanus-acellular pertussis immunization at 2 months of age for preterm infants.
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