title: Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States.
abstract: BACKGROUND
  Findings from animal and human studies confirm that diphtheria and tetanus toxoids and pertussis (DTP) and tetanus vaccinations induce allergic responses; associations between childhood vaccinations and subsequent allergies have been reported recently.
  
  
  OBJECTIVE
  The association of DTP or tetanus vaccination with allergies and allergy-related respiratory symptoms among children and adolescents in the United States was assessed.
  
  
  METHODS
  Data were used from the Third National Health and Nutrition Examination Survey on infants aged 2 months through adolescents aged 16 years. DTP or tetanus vaccination, lifetime allergy history, and allergy symptoms in the past 12 months were based on parental or guardian recall. Logistic regression modeling was performed to estimate the effects of DTP or tetanus vaccination on each allergy.
  
  
  RESULTS
  The odds of having a history of asthma was twice as great among vaccinated subjects than among unvaccinated subjects (adjusted odds ratio, 2.00; 95% confidence interval, 0.59 to 6.74). The odds of having had any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects (adjusted odds ratio, 1.63; 95% confidence interval, 1.05 to 2.54). The associations between vaccination and subsequent allergies and symptoms were greatest among children aged 5 through 10 years.
  
  
  CONCLUSIONS
  DTP or tetanus vaccination appears to increase the risk of allergies and related respiratory symptoms in children and adolescents. Although it is unlikely that these results are entirely because of any sources of bias, the small number of unvaccinated subjects and the study design limit our ability to make firm causal inferences about the true magnitude of effect.
authors.affiliation: UCLA School of Public Health, Department of Epidemiology, Los Angeles, Calif 90095-1772, USA. ehurwitz@ucla.edu
authors.forename: E L
authors.initials: EL
authors.lastname: Hurwitz
authors.forename: H
authors.initials: H
authors.lastname: Morgenstern
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001249:Asthma / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D016001:Confidence Intervals; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D007223:Infant; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D011247:Pregnancy; D015995:Prevalence; D012042:Registries; D012307:Risk Factors; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000009:adverse effects*
chemical_list: D015721:Diphtheria-Tetanus-Pertussis Vaccine