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Simultaneous immunization with B.C.G., diphtheria-tetanus, and oral poliomyelitis vaccines in children aged 13-14
Insights
Simultaneous vaccination with BCG, diphtheria-tetanus toxoid, and oral poliovaccine is effective, though diphtheria toxoid caused local reactions. Current recommendations exclude diphtheria toxoid for simultaneous administration.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- Simultaneous vaccine administration can improve immunization rates.
- Previous studies explored combined vaccine schedules in children.
Purpose of the Study:
- To assess the efficacy and safety of simultaneous BCG, diphtheria-tetanus toxoid (DT), and oral poliovaccine (OPV) administration.
- To evaluate the need for booster immunizations at 13-14 years of age.
Main Methods:
- A study involving 628 children aged 13-14 years.
- Vaccines administered simultaneously: BCG, DT (aluminium hydroxide adsorbed), and OPV.
- Serological studies to assess antibody levels.
Main Results:
- Vaccine efficacy was not compromised by simultaneous administration.
- No adverse reactions observed with BCG or OPV.
- 8% of children experienced moderate to severe local reactions to DT vaccine, attributed to diphtheria toxoid.
- Serological data indicated a need for diphtheria, tetanus, and polio immunization at 13-14 years.
Conclusions:
- Simultaneous administration is justified when it overcomes organizational barriers to high immunization rates.
- Due to adverse reactions, simultaneous administration of DT vaccine is not recommended currently.
- Alternative diphtheria toxoid formulations or reduced doses may be considered for future booster immunizations.
- Ongoing serological surveillance is crucial for community immunization program planning.
Abstract:
The simultaneous administration of B.C.G. vaccine, diphtheria-tetanus toxoid aluminium hydroxide adsorbed vaccine, and oral poliovaccine was studied in 628 children aged 13-14 years between 1966 and 1969 in Newham, London. The efficacy of these vaccines was unaffected by administering them at the same time; routine simultaneous administration is considered justified when organizational difficulties prevent the attainment of high immunization rates with the vaccines given separately. No adverse reactions to B.C.G. or oral poliomyelitis vaccines took place, but 8% of children had moderately severe local reactions after diphtheria-tetanus aluminium hydroxide adsorbed vaccine, which were attributed to diphtheria toxoid.Serological studies showed the need for immunization against diphtheria, tetanus, and poliomyelitis at 13-14 years of age. Because of the adverse reactions to diphtheria toxoid, however, simultaneous administration of tetanus toxoid aluminium hydroxide adsorbed, oral poliomyelitis, and B.C.G. vaccines only is recommended at present.An "adult type" diphtheria-tetanus toxoid might overcome the problem of reactions, though in two to three years' time most children aged 13-14 years will have received diphtheria-tetanus-pertussis vaccine in infancy and reinforcement might then be accomplished by a small intradermal dose of the currently available fluid diphtheria-tetanus vaccine.Continued serological studies of diphtheria and tetanus antitoxins and polio antibody are necessary to determine the future need for reinforcement of immunity; such studies should become an essential part of the surveillance of the community immunization programme.