title: Vaccination of children following a previous hypotonic-hyporesponsive episode.
abstract: BACKGROUND
  Hypotonic-hyporesponsive episodes (HHE) were once considered a contraindication to pertussis vaccination.
  
  
  METHODS
  To evaluate the safety of further vaccination, chart review was conducted of 66 children who had experienced an HHE, and who were assessed in one of three special clinics in three capital city tertiary paediatric hospitals. Immediately prior to the HHE, 63 children had received whole-cell pertussis vaccine, three had received acellular pertussis vaccine.
  
  
  RESULTS
  Sixty-four of the 66 children were vaccinated in the special clinic, 59 with pertussis-containing vaccines (55 acellular, four whole-cell), without serious adverse events. There were no HHE after these further vaccinations.
  
  
  CONCLUSIONS
  Previously healthy children who experience HHE reactions can safely continue standard vaccination schedules.
authors.affiliation: National Centre for Immunisation Research and Surveillance of Vaccine Preventable Diseases, Westmead, New South Wales, Australia.
authors.forename: H
authors.initials: H
authors.lastname: Goodwin
authors.forename: M
authors.initials: M
authors.lastname: Nash
authors.forename: M
authors.initials: M
authors.lastname: Gold
authors.forename: T C
authors.initials: TC
authors.lastname: Heath
authors.forename: M A
authors.initials: MA
authors.lastname: Burgess
mesh_terms: D002675:Child, Preschool; D004168:Diphtheria Toxoid / Q000009:adverse effects; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000009:adverse effects; D004338:Drug Combinations; D004342:Drug Hypersensitivity / Q000209:etiology*; D006801:Humans; D007223:Infant; D009123:Muscle Hypotonia / Q000139:chemically induced*; D010567:Pertussis Vaccine / Q000009:adverse effects; D012008:Recurrence; D012189:Retrospective Studies; D013021:South Australia; D013745:Tetanus Toxoid / Q000009:adverse effects; D014611:Vaccination; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D004168:Diphtheria Toxoid; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D004338:Drug Combinations; D010567:Pertussis Vaccine; D013745:Tetanus Toxoid; D014612:Vaccines