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History of convulsions and use of pertussis vaccine
Insights
Children experiencing neurologic events after diphtheria-tetanus-pertussis (DTP) vaccination had higher risks of personal or family convulsion history. Pertussis vaccine may be deferred for children with prior convulsions.
Area of Science:
- Pediatric Neurology
- Vaccine Safety
- Immunology
Background:
- Adverse events following immunization (AEFI) require careful monitoring.
- The diphtheria-tetanus-pertussis (DTP) vaccine is a common childhood immunization.
- Understanding risk factors for neurologic events post-vaccination is crucial.
Purpose of the Study:
- To compare the risk of personal or family history of convulsions in children with neurologic versus nonneurologic adverse events after DTP vaccination.
- To identify specific risk factors associated with neurologic adverse events post-DTP.
Main Methods:
- Analysis of 2062 reports from the CDC's Monitoring System for Adverse Events Following Immunization.
- Comparison of children with neurologic adverse events to those with nonneurologic adverse events after DTP vaccine.
- Statistical analysis of personal and family history of convulsions.
Main Results:
- Children with neurologic events post-DTP had a 7.2-fold higher risk of personal convulsion history and a 4.5-fold higher risk of family convulsion history.
- Both febrile and nonfebrile convulsions post-DTP were significantly linked to personal convulsion history (P < 0.0001).
- Febrile convulsions post-DTP, but not nonfebrile, were significantly linked to family convulsion history.
Conclusions:
- A history of convulsions is a significant risk factor for neurologic adverse events following DTP vaccination.
- Pertussis vaccination should be deferred in children with a personal convulsion history pending evaluation for evolving neurologic disorders.
- Children with identified neurologic disorders should receive the pediatric diphtheria and tetanus toxoids (DT) vaccine to complete immunization series.
Abstract:
Data on 2062 reports from the Monitoring System for Adverse Events Following Immunization, Centers for Disease Control (CDC), were analyzed to compare the risk of a personal or family history of convulsions in children who had a neurologic adverse event after receipt of diphtheria-tetanus-pertussis (DTP) vaccine with those who had a nonneurologic adverse event. Children with a neurologic event after DTP vaccine had a 7.2 times higher risk for personal history of convulsions (95% confidence limits 4.5 to 11.5) and a 4.5 times higher risk for family history of convulsions (95% confidence limits 3.1 to 6.7) than did children with an adverse event that did not affect the nervous system. Children with either a febrile or nonfebrile convulsion after receipt of DTP were significantly more likely to have a personal history of convulsions than children with a nonneurologic adverse event (P less than 0.0001). Children with a febrile convulsion after receipt of DTP but not children with nonfebrile convulsions were significantly more likely to have a family history of convulsions than those with a nonneurologic adverse event. It is recommended that pertussis vaccination be deferred in children with a personal history of a convulsion until it can be determined that an evolving neurologic disorder is not present. If such disorders are found, these children should be given the combined pediatric diphtheria and tetanus toxoids (DT) vaccine to complete the series.