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Simultaneous Administration of a Diphtheria and Tetanus Toxoids and Acellular Pertussis Vaccine With Measles-Mumps-Rubella and Oral Poliovirus Vaccines

Edward P. Rothstein, MD; Henry H. Bernstein, DO; Mary P. Glode, MD; Suzanne Laussucq, MD; Jean Nonenmacher; Sarah S. Long, MD; Jill G. Hackell, MD
Am J Dis Child. 1993;147(8):854-857. doi:10.1001/archpedi.1993.02160320056019.
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• Objective.  —To compare the safety and immunogenicity of Lederle Laboratories' (Pearl River, NY) diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine with diphtheria and tetanus toxoids and whole-cell pertussis (DTwP) vaccine when administered simultaneously with measles-mumps-rubella (MMR) vaccine and trivalent oral poliovirus (OPV) vaccine at 15 to 16 months of age.

Design.  —Randomized and double-blind.

Setting.  —Two general pediatric practices.

Participants.  —Ninety-seven infants, aged 15 to 16 months, who had received three previous DTwP immunizations.

Selection Procedures and Interventions.  —Healthy children received the DTaP or DTwP vaccine. Infants received the MMR vaccine at a separate site and the OPV vaccine concurrently. Blood was obtained on day 0 and at 6 weeks. Adverse events were recorded by parents at specified times after immunization.

Measurements/Results.  —Within 3 days of immunization, DTaP vaccine recipients had less fever, drowsiness, and ir-ritability (P=.01,.04,.01, respectively). They also experienced less tenderness, erythema, and induration (.001,.001, and.002, respectively). There was no difference in the frequency of adverse reactions 6 to 14 days after immunization. Enzyme-linked immunosorbent assays were used to determine all antibody values. Antibody responses to filamentous hemagglutinin and pertussis toxoid were significantly greater in the DTaP group (P=.0001 and.02, respectively). Immune responses to the other measured antigens were similar.

Conclusions.  —Simultaneous administration of the Lederle DTaP with MMR and OPV vaccines did not interfere with antibody response to pertussis antigens measured or measles, mumps, or rubella viruses and was associated with fewer local and systemic adverse events during the first 3 days following immunization when compared with the simultaneous administration of the DTwP, OPV, and MMR vaccines. We conclude that the DTaP vaccine can be administered at 15 months of age concurrently with the MMR and OPV vaccines.(AJDC. 1993;147:854-857)

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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