Simultaneous administration of a diphtheria and tetanus toxoids and acellular pertussis vaccine with measles-mumps-rubella and oral poliovirus vaccines.
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.


METHODS
Randomized and double-blind.


METHODS
Two general pediatric practices.


METHODS
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.


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.
Temple University School of Medicine, Philadelphia, Pa.
E P
EP
Rothstein
H H
HH
Bernstein
M P
MP
Glode
S
S
Laussucq
J
J
Nonenmacher
S S
SS
Long
J G
JG
Hackell
D000855:Anorexia / Q000139:chemically induced / Q000453:epidemiology; D000907:Antibodies, Bacterial / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D001886:Bordetella pertussis / Q000276:immunology; D003017:Clostridium tetani / Q000276:immunology; D003353:Corynebacterium diphtheriae / Q000276:immunology; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D004311:Double-Blind Method; D004338:Drug Combinations; D004797:Enzyme-Linked Immunosorbent Assay; D004890:Erythema / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D005334:Fever / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007508:Irritable Mood / Q000187:drug effects; D008297:Male; D008458:Measles Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D008459:Measles virus / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D009109:Mumps virus / Q000276:immunology; D017955:Poliovirus / Q000276:immunology; D011055:Poliovirus Vaccine, Oral / Q000008:administration & dosage* / Q000009:adverse effects; D012411:Rubella Vaccine / Q000008:administration & dosage* / Q000009:adverse effects; D012412:Rubella virus / Q000276:immunology; D012894:Sleep Stages / Q000187:drug effects
D000907:Antibodies, Bacterial; D000914:Antibodies, Viral; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004338:Drug Combinations; D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine; D011055:Poliovirus Vaccine, Oral; D012411:Rubella Vaccine