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DTP reactions and serologic response with a reduced dose schedule
Insights
A modified DTP vaccine dose significantly reduced side effects like fever and behavioral changes in infants. Antibody responses remained protective, demonstrating the modified vaccine
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- The DTP (diphtheria, tetanus, and pertussis) vaccine is crucial for infant immunization.
- Standard DTP vaccine doses can cause significant side effects, prompting research into modified regimens.
- Evaluating vaccine efficacy and safety in infant populations is essential for public health.
Purpose of the Study:
- To compare the safety and immunogenicity of a standard versus a modified DTP vaccine dose in infants.
- To assess side effects, including febrile reactions, behavioral changes, and local reactions.
- To determine antibody responses against diphtheria, tetanus, and pertussis.
Main Methods:
- A double-blind study involving infants receiving either standard (0.5 ml) or modified (0.25 ml) DTP vaccine doses.
- Immunizations were administered for the primary series at 2, 4, and 6 months, and a booster at 18 months.
- Side effects and antibody titers were monitored in 80 children for the primary series and 73 for the booster.
Main Results:
- The modified DTP vaccine regimen significantly reduced febrile reactions and behavioral changes compared to the standard dose.
- Local reaction incidence was lower with the modified dose during the primary series but similar for the booster.
- All infants achieved protective antibody titers for diphtheria and tetanus; pertussis titers were comparable and protective, with one standard-dose recipient falling below the threshold post-booster.
Conclusions:
- A modified, reduced DTP vaccine dose is a safer alternative, showing fewer adverse reactions in infants.
- The modified DTP vaccine regimen maintains adequate serologic protection against diphtheria, tetanus, and pertussis.
- This modified DTP vaccine approach offers a promising strategy for improving infant vaccination safety without compromising immunogenicity.
Abstract:
In a double-blind study, infants received standard (0.5 ml) or modified (0.25 ml) doses of DTP vaccine for the primary series of three immunizations administered at 2, 4, and 6 months of age and the booster immunization at 18 months. Side effects and antibody responses were determined in 80 children who completed the primary series and 73 who received the booster. The modified regimen was associated with significantly reduced febrile reactions and behavioral changes after the primary series and booster inoculation: 63.2% of those who received the standard dose had febrile reactions, compared to 42.3% who received the modified dose during the primary series; a similar difference was observed with the booster. Only 47.2% of the reduced dosage recipients demonstrated marked behavioral changes, and 62.4% of the standard vaccine recipients had comparable reactions. An even larger difference (33.3% vs 64.7%) was noted at the time of the booster. The modified vaccine produced a local reaction incidence of 58.5%, compared to 72.6% in the control population during the primary immunization series; no differences were noted in local reactions with the booster dose. All patients had serologic evidence of protective titers against diphtheria and tetanus. After the primary immunization series, 97.6% and 97.3% of the infants given the modified and standard doses, respectively, had pertussis agglutinin titers of greater than or equal to 1:16. One patient who received the standard dosage had a titer of less than 1:16 one month after the booster immunization, whereas all those given the modified dose had titers greater than or equal to 1:16. Geometric mean titers of pertussis agglutinins were higher in the standard vaccine recipients after the primary series, but were similar in the two study groups before and after the 18-month immunization.