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Pertussis immunisation and serious acute neurological illness in children
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.
Abstract:
The first 1000 cases notified to the National Childhood Encephalopathy Study were analysed. The diagnoses included encephalitis/encephalopathy, prolonged convulsions, infantile spasms, and Reye's syndrome. Eighty-eight of the children had had a recent infectious disease, including 19 with pertussis. Only 35 of the notified children (3.5%) had received pertussis antigen within seven days before becoming ill. Of 1955 control children matched for age, sex, and area of residence, 34 (1.7%) had been immunised with pertussis vaccine within the seven days before the date on which they became of the same age as the corresponding notified child. The relative risk of a notified child having had pertussis immunisation within that time interval was 2.4 (p less than 0.001). Of the 35 notified children, 32 had no previous neurological abnormality. A year later two had died, nine had developmental retardation, and 21 were normal. A significance association was shown between serious neurological illness and pertussis vaccine, though cases were few and most children recovered completely.