Simultaneous administration of a diphtheria and tetanus toxoids and acellular pertussis vaccine with measles-mumps-rubella and oral poliovirus vaccines
E. P. Rothstein, H. H. Bernstein, M. P. Glode, S. Laussucq, J. Nonenmacher, S. S. Long and J. G. Hackell
Temple University School of Medicine, Philadelphia, Pa.
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 irritability (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.
