title: Simultaneous vaccination of Chinese applicants for a United States immigrant visa.
abstract: BACKGROUND
  Simultaneous vaccination is still uncommon in China, and many Chinese people are quite concerned about the adverse reactions because few data regarding the adverse reactions of simultaneous vaccination in Chinese people have been reported. The objective of this study was to evaluate the safety of simultaneous vaccination and the frequency of adverse reactions following simultaneous vaccinations in Chinese applicants for a United States immigrant visa.
  
  
  METHODS
  We conducted a prospective observational study in 772 applicants receiving required vaccination in Guangdong International Travel Healthcare Center. The vaccines required for vaccination included diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP), adult formulation tetanus and diphtheria toxoids (Td), haemophilus influenzae type-b conjugate vaccine (Hib), oral polio vaccine (OPV), hepatitis B vaccine (HepB), combined measles mumps rubella vaccine (MMR), varicella vaccine (Var), and influenza vaccine (Inf), pneumococcal polysaccharide vaccine (PPV). Data on adverse reactions were collected by questionnaires.
  
  
  RESULTS
  Seven hundred and seventy-two participants have received a total of 2533 doses of different vaccines, and 49.6% of the participants reported adverse reactions within 7 days following vaccination, with 39.8%(307/772) local reactions and 20.2%(156/772) systemic reactions. There were no allergic reactions. Only one vaccinee visited hospital seeking treatment due to fever, and recovered well. The most frequent local reaction was pain at the injection site (260/772, 33.7%), especially in the case of PPV vaccination, 61.2% (63/103) vaccinees who received PPV complained of pain at the site of injection, while the most frequent systemic reaction was fever (84/772, 10.9%). Pain and fever were all temporary reactions and resolved within 72h. Logistic regression analysis found that females experienced adverse reactions more frequently than males [(local reactions: female:male=41.7%(187/448):37%(120/324), p=0.04; systemic reactions: female:male=23%(103/448):16.4%(53/324), p=0.026)]; vaccinees given PPV developed local reactions more frequently than those receiving the other vaccines. The number of vaccines has no significant influence on adverse reactions.
  
  
  CONCLUSIONS
  Simultaneous vaccination is feasible for Chinese applicants for a United States immigrant visa because the adverse reactions are mostly mild and temporary. Our data suggest that more Chinese people should be encouraged to receive simultaneous vaccination if the time is limited so as to reduce the risk of vaccine-preventable diseases.
authors.affiliation: Guangdong International Travel Healthcare Center, Guangzhou 510130, China.
authors.forename: Li
authors.initials: L
authors.lastname: Hua
authors.forename: He
authors.initials: H
authors.lastname: Hongtao
authors.forename: Wang
authors.initials: W
authors.lastname: Shunqin
authors.forename: Gao
authors.initials: G
authors.lastname: Jinping
authors.forename: Chen
authors.initials: C
authors.lastname: Jiandong
authors.forename: Lei
authors.initials: L
authors.lastname: Zhaoliang
authors.forename: Feng
authors.initials: F
authors.lastname: Xinwen
mesh_terms: D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D019433:Chickenpox Vaccine / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002681:China / Q000208:ethnology; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D004641:Emigration and Immigration; D005260:Female; D018073:Haemophilus Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D017325:Hepatitis B Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects; D008875:Middle Aged; D022242:Pneumococcal Vaccines / Q000008:administration & dosage / Q000009:adverse effects; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage / Q000009:adverse effects; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D017778:Vaccines, Combined / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D019433:Chickenpox Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D018073:Haemophilus Vaccines; D017325:Hepatitis B Vaccines; D022542:Measles-Mumps-Rubella Vaccine; D022242:Pneumococcal Vaccines; D011054:Poliovirus Vaccine, Inactivated; D017778:Vaccines, Combined