title: [Increase in localised symptoms in 4-year-olds following revaccination with DaPT-IPV].
abstract: OBJECTIVE
  To present an inventory of notifications of serious local reactions after revaccination of 4-year-old children with DaPT-IPV (diphtheria vaccine, acellular pertussis vaccine, tetanus vaccine and poliomyelitis vaccine), who had been vaccinated as a toddler with whole-cell pertussis combination vaccine (DwPT-IPV-Hib) and/or (from 2005 onward) with the acellular pertussis combination vaccine (DaPT-IPV-Hib).
  
  
  METHODS
  Descriptive inventory
  
  
  METHODS
  Via an enhanced passive surveillance system professionals and private individuals can report an adverse event following vaccination within the Dutch national vaccination programme. The number of notifications of local side effects was related to the total number of vaccinated children registered in Praeventis, a national vaccination register in which information on an individual level is available.
  
  
  RESULTS
  In 2008, we received an increasing number of notifications of serious local reactions after the revaccination of 4-year-olds with acellular DPT-IPV (average 3 per 1000 vaccinated children) with a peak in October/November. These children had also been vaccinated with acellular pertussis vaccine as infants. The symptoms of swelling and redness of sometimes the entire upper arm arose mostly the day after the vaccination and disappeared within 4 to 5 days without sequelae.
  
  
  CONCLUSIONS
  Although the mechanisms underlying these serious local reactions are still not well understood, they do not imply an acute allergic reaction or infection and so medication against such reactions is not usually necessary.
authors.affiliation: Centrum Infectieziektebestrijding, Rijks Instituut voor Volksgezondheid en Milieu, Bilthoven, The Netherlands.
authors.forename: Silke
authors.initials: S
authors.lastname: David
authors.forename: Patricia
authors.initials: P
authors.lastname: Vermeer-de Bondt
authors.forename: Nicoline
authors.initials: N
authors.lastname: van der Maas
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000592:standards*; D005260:Female; D018073:Haemophilus Vaccines; D006801:Humans; D008297:Male; D009426:Netherlands; D010567:Pertussis Vaccine / Q000009:adverse effects* / Q000276:immunology; D011054:Poliovirus Vaccine, Inactivated; D011159:Population Surveillance; D012307:Risk Factors; D012449:Safety; D014611:Vaccination / Q000592:standards*; D017778:Vaccines, Combined / Q000009:adverse effects* / Q000276:immunology
chemical_list: C513012:DTP-IPV-Hib vaccine; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D018073:Haemophilus Vaccines; D010567:Pertussis Vaccine; D011054:Poliovirus Vaccine, Inactivated; D017778:Vaccines, Combined