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DTaP not associated with increased seizure risk in early childhood
Huang WT. Pediatrics. 2010;126:263-269.
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In the 3 days after diphtheria and tetanus toxoids and acellular pertussis vaccination, researchers reported no significant increase in the risk for seizure among children aged 6 weeks to 23 months.
Given the known association of seizure risk and whole-cell pertussis vaccine combined with diphtheria and tetanus toxoids (DTP), researchers conducted a population-based study to analyze the risk associated with DTaP vaccination. From 1997 through 2006, they used risk-interval cohort and self-controlled case series analyses on data collected from seven managed care organizations that also participate in the CDC’s Vaccine Safety Datalink. Data for 433,654 children aged between 6 weeks and 23 months who had not received DTP vaccination during the study period were included.
The exposed period was defined as 4 person-days after each dose; the unexposed period was classified as observation periods outside of the exposed periods, according to the researchers. The risk-interval method compared seizure incidence between the exposed and unexposed cohorts, and the self-controlled case series analyses compared a patient’s exposed and unexposed periods.
The researchers reported 7,191 seizures, 112 of which occurred within 0 to 3 days of vaccination. In addition, DTaP vaccination was not associated with a significantly increased risk for seizure in both the cohort and self-controlled case series analyses when stratified by dose number and post-vaccination risk interval. Within 0 to 3 days of vaccination, the incidence rate ratio for seizures across all doses was 0.87 (95% CI, 0.72-1.05) in cohort and 0.91 (95% CI, 0.75-1.10) in self-controlled case series analyses.
“Our findings provide reassuring evidence that the vaccine is not associated with acute seizure events and is safe for routine immunization in early childhood,” the researchers wrote.
Whole cell DPT vaccine was a major cause of febrile seizures in children. The authors present evidence in this study that the improved acellular pertussis vaccines are free of this association. With all of the negative attention given to vaccine safety scares, it is good to see studies confirming that our vaccine supply is getting safer. Parents should be more reassured now than they were two decades ago and hopefully this will continue to improve.
– Steven B. Black, MD
Infectious Diseases in Children Editorial Board
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