Encephalopathy pertussis vaccine

Finally, Gangarosa and colleagues have reviewed in detail the so-called pertussis vaccine encephalopathy. Seven epidemiological studies have been conducted they show that neurological reactions are exceedingly rare with whole-cell pertussis vaccines (SEDA-21, 329). 

General contraindications to vaccine administration include a history of anaphylactic reaction to a previous dose or an unexplained encephalopathy occurring within 7 days of a dose of pertussis vaccine. Immunosuppression and pregnancy are temporary contraindications to live vaccines. Whenever possible, transplant patients should be immunized before transplantation. Live vaccines generally are not given after transplantation. 

In the early 1980s there were concerns about the safety of whole cell pertussis vaccines in particular, it was claimed by some that the vaccine was associated with sudden infant death syndrome and encephalopathy [21 ]. Immunization rates fell, and many vaccines were withdrawn from the market. However, epidemiological studies have consistently failed to identify an association. It has been recently argued that such reactions may have occurred in metaboli-cally vulnerable children, specifically those with defects in fatty acid oxidation, in whom the combination of anorexia and fever due to the vaccine may have resulted... 

Systemic reactions, such as moderate fever, occur in 3% to 5% of those receiving vaccines. Very rarely, high fever, febrile seizures, persistent crying spells, and hypotonic hyporesponsive episodes occur after vaccination. There are only two absolute contraindications to pertussis administration an immediate anaphylactic reaction to a previous dose or encephalopathy within 7 days of a previous dose, with no evidence of other cause. 

II. Pertussis antigen-containing vaccines (for example DTaP, DTP, P, DTP-Hib) A. Anaphylaxis or anaphylactic shock B. Encephalopathy (or encephalitis) C. Any acute complication or sequel (including death) of the above events 0-4 hours 0-72 hours Not applicable... 

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