DTP VACCINE REACTIONS: EFFECT OF PRIOR REACTIONS ON RATE OF SUBSEQUENT REACTIONS

Abstract

It is generally presumed that children who have had reactions to DTP immunization will be more likely to have similar or more severe reactions upon subsequent immunization. To evaluate this contention, we studied the rates of selected reactions in 4,058 children in whom we had similar reaction data recorded for a proceeding DTP immunization. Only reactions occurring within 48 hours of immunization were included. There were 1,195 children in whom rectal temperatures were recorded at 3 and 6 hours after both immunizations. Of these, the rate of occurrence of fever (temp ≥ 38°C) after the second immunization was 38.5% in children who in previous immunization had temperatures ≥38°C and 52.8% in those who previously had temperatures ≥38°C (p<0.0001). The rates of other reactions in 4,058 children as a function of previous reactions are as follows (no prior reaction/prior reaction): local redness, 28.5%/44.3% (p<0.0001); local swelling, 32.0%/45.9% (p<0.0001); local pain, 39.6%/49.0% (p<0.0001); drowsiness, 27.3%/36.7% (p<0.0001); fretfulness, 49.4%/57.3% (p<0.0001); vomiting, 4.9%/8.1% (p<0.02); eating less, 18.2%/ 22.7% (p<0.004); persistent screaming, 3.9%/7.2% (p<0.02).

These data strongly support the presumption that children who have had previous reactions following DTP immunization are more likely to have similar reactions upon subsequent immunization.

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