Allergic disease at the
age of 7 years after pertussis vaccination in infancy: results from the
follow-up of a randomized controlled trial of 3
vaccines.
Nilsson L, Kjellman NI, Bjorksten
B.
Division of Paediatrics, the Department of Molecular and
Clinical Medicine, Faculty of Health Sciences, Linkoping University,
Linkoping, Sweden. Lennart.B.Nilssonis@lio.se
OBJECTIVE: To
prospectively assess sensitization rates and the development of allergic
diseases in a follow-up of a randomized controlled pertussis vaccine
trial. SETTING: Two-month-old infants were the subject of this
double-blind study in 1992 in a collaboration between the Pediatric
Clinic and the Primary Care Centers in Linkoping. PATIENTS AND
INTERVENTION: Allergic diseases were evaluated in 667 children, who were
randomized to 1 of 4 vaccine groups: a 2-component, a 5-component, or a
whole cell pertussis vaccine (all of which were administered with the
diphtheria and tetanus toxoids vaccine) and the diphtheria and tetanus
toxoids vaccine alone. Allergy development was assessed by
questionnaires (n = 667) and skin prick tests (n = 538) at the age of 7
years. MAIN OUTCOME MEASURES: Allergic diseases and skin prick test
results at the age of 7 years. RESULTS: The cumulative incidence of
allergic diseases was 34.9%, and was similar in the 4 groups
(33.3%-37.3%, P =.89), even after adjusting for family history, sex,
pets, dampness, environmental smoking at home, and other living
conditions. Positive skin prick test results were more prevalent,
however, after vaccination with the 2-component acellular vaccine
(19.4%) than in the other 3 groups (11.1%-13.5%, adjusted for
confounding factors, P =.01). Furthermore, allergic rhinoconjunctivitis
was more common in children who were initially immunized with the
2-component pertussis vaccine and received a booster dose with an
acellular vaccine compared with those who received no booster
vaccination (relative risk, 3.6; 95% confidence interval, 1.1-12.0).
CONCLUSION: Pertussis vaccination in infancy with any of these vaccines
was not associated with allergic manifestations at the age of 7 years,
apart from a higher prevalence of positive skin prick test results after
an experimental 2-component vaccine, which is no longer in
use.