Apnea/bradycardia non-recurrent with DTwP vaccine in low-birth-weight infants

NEW ORLEANS – Immunization with diphtheria, tetanus and whole cell pertussis did not increase or cause recurrence risk for apnea/bradycardia in low birth weight infants, according to an abstract presentation at IDWeek 2016.

Apnea was common among premature, very-low-birth-weight infants at the time they received their first therapy immunizations,” Pablo J. Sanchez, MD, a neonatologist and pediatric infectious disease specialist at Nationwide Children’s Hospital and Infectious Diseases in Children Editorial Board member, said in an interview. “When we look at it prospectively, we did not find a significant increase in apnea, although there was an increase in the rate of apneic events.”

Pablo J. Sanchez

Researchers, including Morvarid Elahi, MD, enrolled 149 very–low-birth-weight (VLBW) infants in a prospective, randomized, double-blind, cross-over study to evaluate the occurrence of apnea/bradycardia (A/B) with diphtheria, tetanus and whole cell pertussis (DTwP) vaccine compared with placebo. Mean infant gestational age was 27 weeks, weighed an average 1,000 g at birth and 99% had a history of apnea.

Between 1993 and 1997, researchers randomly selected infants to be injected with DTwP or placebo intramuscularly in the NICU at Parkland Hospital and monitored for 3 days. On the fourth day, control infants received DTwP and experimental infants received placebo. The researchers investigated specifically for A/B recurrence or a 50% increase of A/B events in the 3 days following DTwP vaccination.

Study analysis showed that 29 infants experienced A/B recurrence or a 50% increase of A/B episodes after DTwP immunization compared with 18 infants vaccinated with placebo (P = .11). In addition, one infant experienced fever with DTwP, one infant had a hyporesponsive episode with placebo and 13 infants underwent sepsis (DTwP group n = 7; placebo group n = 6).

“From baseline to post-DTwP, that rate was significantly increased in apnea compared with sterile water,” Sanchez told Infectious Diseases in Children. “That could be due to the fact that those patients in the sterile water group had more apnea than those in the DTwP group. Apnea was frequent in both groups argues for respiratory monitoring at the time infants are immunized.” – by Kate Sherrer

Reference:

Elahi M, et al. Abstract 1687. Presented at: IDWeek; October 25-30, 2016; New Orleans.

Disclosure: Elahi reports no relevant financial disclosures. Please see the full study for a list of all other researchers’ financial disclosures.