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Pertussis immunisation and serious acute neurological illness in children

D L Miller, E M Ross, R Alderslade

    British Medical Journal (Clinical Research Ed.)
    |May 16, 1981
    PubMed

    Insights

    This study investigated serious neurological illness in children and its potential link to the pertussis vaccine. While a significant association was found, most children recovered, indicating a rare adverse event.

    Area of Science:

    • Pediatric Neurology
    • Vaccine Safety Research
    • Epidemiology of Childhood Illnesses

    Background:

    • The National Childhood Encephalopathy Study analyzed 1000 notified cases.
    • Diagnoses included encephalitis/encephalopathy, prolonged convulsions, infantile spasms, and Reye's syndrome.
    • Recent infectious diseases were noted in 88 children, with 19 having pertussis.

    Purpose of the Study:

    • To investigate the association between serious neurological illness in children and recent pertussis vaccination.
    • To determine the relative risk of neurological events following pertussis immunization.

    Main Methods:

    • Analysis of 1000 childhood encephalopathy cases and 1955 matched controls.
    • Comparison of pertussis immunization rates within seven days prior to illness onset between cases and controls.
    • Calculation of relative risk for neurological illness associated with pertussis vaccine.

    Main Results:

    • 3.5% of cases and 1.7% of controls received pertussis vaccine within seven days before illness/index date.
    • A statistically significant relative risk of 2.4 (p < 0.001) was observed for pertussis immunization preceding neurological illness.
    • Of 35 notified children with recent pertussis immunization, most had no prior neurological abnormality; outcomes varied, with some experiencing developmental issues.

    Conclusions:

    • A significant association exists between serious neurological illness and pertussis vaccine administration.
    • Despite the association, the number of affected cases was small, and most children demonstrated complete recovery.
    • Further research is warranted to understand the specific mechanisms and incidence of these rare adverse events.

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