title: Safety of reduced-antigen-content tetanus-diphtheria-acellular pertussis vaccine in adolescents as a sixth consecutive dose of acellular pertussis-containing vaccine.
abstract: OBJECTIVE
  The safety of a booster dose of a reduced-antigen-content tetanus-diphtheria-acellular pertussis (Tdap) vaccine was evaluated in adolescents previously vaccinated with five doses of acellular pertussis-containing vaccine.
  
  
  METHODS
  Adolescents (n = 319) previously vaccinated with either 5 doses of diphtheria-tetanus-acellular pertussis (DTaP) (n = 193) or 4 doses of DTaP plus another acellular pertussis-containing vaccine received one dose each of Tdap and hepatitis A vaccine in a double-blinded, randomized, crossover trial. Rates of adverse events (AEs) after vaccination with Tdap versus hepatitis A and rates of local AEs among adolescents vaccinated with Tdap (sixth acellular pertussis-containing vaccine dose) versus rates in these same individuals after vaccination with their fifth DTaP dose were assessed.
  
  
  RESULTS
  After Tdap, pain (63.6%), redness (51.7%), and swelling (41.4%) were the most frequently reported AEs. Large injection site swelling (swelling > 100 mm, arm circumference increase > 50 mm or diffuse swelling interfering with daily activities) occurred in three adolescents and resolved without sequelae. After the sixth dose of acellular pertussis-containing vaccine, adolescents reported more pain and less redness and swelling compared with incidences of these AEs reported when these same individuals received their fifth DTaP dose.
  
  
  CONCLUSIONS
  These results suggest that Tdap is well tolerated as a sixth consecutive dose of acellular pertussis-containing vaccine.
authors.affiliation: Children's Hospital, Johannes Gutenberg University, Mainz, Germany.
authors.forename: Fred
authors.initials: F
authors.lastname: Zepp
authors.forename: Markus
authors.initials: M
authors.lastname: Knuf
authors.forename: Pirmin
authors.initials: P
authors.lastname: Habermehl
authors.forename: Wilma
authors.initials: W
authors.lastname: Mannhardt-Laakmann
authors.forename: Barbara
authors.initials: B
authors.lastname: Howe
authors.forename: Leonard R
authors.initials: LR
authors.lastname: Friedland
mesh_terms: D000293:Adolescent; D000942:Antigens, Bacterial / Q000008:administration & dosage* / Q000009:adverse effects*; D002648:Child; D018592:Cross-Over Studies; D004165:Diphtheria / Q000517:prevention & control; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007115:Immunization Schedule; D015994:Incidence; D008297:Male; D011446:Prospective Studies; D012720:Severity of Illness Index; D013742:Tetanus / Q000517:prevention & control; D016896:Treatment Outcome; D014611:Vaccination / Q000009:adverse effects; D014917:Whooping Cough / Q000517:prevention & control
chemical_list: D000942:Antigens, Bacterial; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines