Pertussis vaccine adverse effects

Adverse effects on the nervous system that have at least temporally been associated with rubella vaccination include myehtis, myeloradiculitis (SEDA-2, 268) (SEDA-20, 292), meningomyelitis (SEDA-10,291), ence-phahtis (SEDA-5, 308), peripheral neuropathy (SEDA-12, 284), facial or peripheral paresthesia (SEDA-11, 295) (SEDA-12, 284), and carpal tunnel syndrome (SEDA-12, 284). In many of these cases the causal relation was doubtful. The authors of the report of the Institute of Medicine, National Academy of Sciences, Washington, DC (1991) entitled Adverse Effects of Pertussis and Rubella Vaccines (38) considered that there was insufficient evidence to indicate either the presence or absence of a causal relation between RA 27/3 rubella vaccine and radiculoneuritis and other neuropathies. 

However, the authors of the report of the Institute of Medicine, National Academy of Sciences, Washington, DC (1991) entitled Adverse Effects of Pertussis and Rubella Vaccines (38) considered that there was insufficient evidence to indicate either the presence or absence of a causal relation between RA 27/3 rubella vaccine and thrombocytopenic purpura. 

Howson CP, Howe CJ, Fineberg HV, editors. Adverse Effects of pertussis and rubella vaccines. A report of the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines. Washington, DC National Academy Press, 1991. 

Eight children developed urticaria within 30 minutes after administration of a diphtheria -I- tetanus -I- acellular pertussis (DTaP) vaccine that contained gelatin as a stabilizer (38). None of the children had anti-gelatin IgE, and only two had detectable concentrations of antitoxoid IgE to diphtheria and pertussis toxoids. No methods to measure anti-thiomersal and anti-alum IgE were available. The authors recommended the development of such methods, which could improve research into the causality of adverse effects of this sort. 

The risks of adverse effects after immnnization against diphtheria, pertussis, tetanus, pohomyehtis, measles, and tuberculosis have been discussed in the framework of the WHO Expanded Program on Immunization and compared with the complication rate following natural disease (40). Table 8 presents a comparison of the estimated risks of adverse reactions after DTP immunization with the complication rates of natural whooping cough, while Table 9 shows a similar comparison for measles immunization and natural measles. The authors concluded that no vaccine is without adverse effects, but that the risks of serious complications from vaccines used in WHO s Expanded Program on Immunization are much lower than the risks from the natural disease. 

The reports of the Institute of Medicine, National Academy of Sciences, Washington (on adverse events after pertussis and mbeUa immnnization (SED-12, 817) (SED-12, 825) and on adverse events after immunization against tetanus, diphtheria, measles, mumps, poliomyelitis, H. influenzae type b, and hepatitis B (SEDA-18,325) have provided useful reviews (13,14). The 1996 Update on vaccine side effects, adverse reactions, contraindications,... 

Howson, C.P. Fineberg, H.V. The ricochet of magic bullets Summary of the Institute of Medicine Report, Adverse Effects of Pertussis and Rubella Vaccines. Pediatrics 1992, Feb., 89 (2), 318-324. 

In the USA, the National Childhood Vaccine Injury Act of 1986 established the National Vaccine Injury Compensation Program as a federal no-fault compensation system for individuals who may have been injured by specific vaccines. This compensation program relies on a Vaccine Injury Table that lists the vaccines that are covered by the program, as well as injuries, disabilities, illnesses, and conditions (including death) for which compensation may be awarded. To better reflect current scientific knowledge about vaccine injuries, the Vaccine Injury Table was revised in 1995 and has been subsequently further modified. The latest modification, which became effective on December 1, 2004, is shown in Table 7. This revision took into account a review of the literature on specific adverse consequences of pertussis and rubella vaccines performed and published by the lOM (SED-12, 817) (SED-12, 825). In addition to the seven vaccines (diphtheria, pertussis, tetanus, measles, mumps, rubella, and poliomyelitis) included in the first Vaccine Injury Table, the 1997 revision includes hepatitis B, Hemophilus influenzae type b, and Varicella vaccines, as well as any future licensed vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) for routine administration to children (38). 

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