Safety of a fifth dose of diphtheria and tetanus toxoid and acellular pertussis vaccine in children experiencing extensive, local reactions to the fourth dose

Department of Pediatrics, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, MD, USA.
The Pediatric Infectious Disease Journal (Impact Factor: 2.72). 05/2008; 27(5):464-5. DOI: 10.1097/INF.0b013e31816591f7
Source: PubMed


Extensive local reactions have been reported after booster doses of diphtheria and tetanus toxoid and acellular pertussis vaccine, but few data are available on revaccination after these reactions. Of 20 children with extensive local reactions after dose 4, only 4 experienced entire upper arm swelling and 7 had swelling >5 cm after dose 5. These reactions were well tolerated and support revaccination.

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    • "The consensus view from studies in the mouse model is that wP vaccines and 69 previous infection confer better protective immunity than aP vaccines because they induce 70 Th1 cells and associated opsonizing antibodies, with a minor contribution by Th17 cells 71 (Table 1). In contrast, the less effective aP vaccines induce a mixed Th2 and Th17 responses 72 (Ross et al., 2013), but the Th2 component appears to be redundant to protection and, together 73 with associated IgE (Ryan et al., 2000), may even be the culprits in rare type hypersensitivity 74 reactions seen in children after a 4 th or 5 th dose of the aP vaccines (Rennels et al., 2008). This 75 pattern of immune responses induced by the pertussis vaccines is generally similar in humans 76 and mice. "
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