Reputed Brain Damage and 'Serious' Reactions From DTP Vaccines-Reply FREE

Steve Rosenthal, MD, MPH; Robert T. Chen, MA, MD; Steve Hadler, MD

Arch Pediatr Adolesc Med. 1997;151(1):108. doi:10.1001/archpedi.1997.02170380111027.

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ABSTRACT

ABSTRACT | REFERENCES

We disagree with Dr Sepkowitz that examining the Vaccine Adverse Event Reporting System for rare serious events casts doubt on the safety of vaccines. Demonstrating that reported adverse events after the the administration of the acellular pertussis vaccine are (1) rare after millions of doses have been used (vs only thousands used in prelicensure clinical trials) and (2) less common than similar events reported after the administration of the whole-cell pertussis vaccine should help instill public confidence in a vaccine that historically has been the most feared.

While controversy remains about whether the whole-cell pertussis vaccine has been proven to be a cause of permanent neurologic damage,^1-3 a consensus exists that the evidence is consistent with a causal relationship between the whole-cell pertussis vaccine and acute encephalopathy, with an attributable risk between 0 and 10.5 cases per million doses of whole-cell pertussis vaccine.⁴ As Dr Sepkowitz

REFERENCES

ABSTRACT | REFERENCES

Miller D, Madge N, Diamond J, Wadsworth J, Ross E. Pertussis immunisation and serious acute neurological illnesses in children . BMJ . 1993;;307:1171-1176.

Stratton KR, Howe CJ, Johnston RB Jr, eds. DPT Vaccine and Chronic Nervous System Dysfunction: A New Analysis . Washington, DC: National Academy Press; 1994;.

Committee on Infectious Diseases. The relationship between pertussis vaccine and central nervous system sequelae: continuing assessment . Pediatrics . 1996;;97:279-281.

Howson CP, Howe CJ, Fineberg HV, eds. Adverse Effects of Pertussis and Rubella Vaccines . Washington, DC: National Academy Press; 1991;:65-124.

Greco D, Salmaso S, Mastrantonio P, et al. A controlled trial of two acellular vaccines and one whole-cell vaccine against pertussis . N Engl J Med . 1996;; 334:341-348.

Gustaffson L, Hallander HO, Olin P, Relzenstein E, Storsaeter J. A controlled trial of a two-component acellular, a five-component acellular, and a whole-cell pertussis vaccine . N Engl J Med . 1996;;334:349-355.

Chen RT, Rosenthal S. An errant critique that misses the mark . Arch Pediatr Adolesc Med . 1996;;150:464-465.

Edward KM, Decker MD. Acellular pertussis vaccines for infants . N Engl J Med . 1996;;334:391-392.

Rosenthal S, Chen R. The reporting sensitivities of two passive surveillance systems for vaccine adverse events . Am J Public Health . 1995;;85:1706-1709.

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