title: Vaccine safety implications of Ontario, Canada's switch from DTaP-IPV to Tdap-IPV for the pre-school booster.
abstract: Ontario, Canada, replaced the 4-6 year old diphtheria (D, d), tetanus (T), acellular pertussis (aP, ap) and polio (IPV) booster from DTaP-IPV to Tdap-IPV in May 2012. We assessed the impact of this replacement on the rate and types of reported adverse events following immunization (AEFIs). We used AEFIs reported among 4-6 years olds, through the provincial surveillance system, following administration of DTaP-IPV or Tdap-IPV from 2009 to 2013. Reporting rates per 100,000 doses distributed were calculated using publicly funded doses distributed as the denominator. A total of 204 AEFIs were reported (DTaP-IPV, n=182; Tdap-IPV, n=22). AEFI reporting rates were 33.1 and 6.3 per 100,000 doses distributed for DTaP-IPV and Tdap-IPV, respectively. Injection site reaction rate was lower for Tdap-IPV compared with DTaP-IPV (1.7 vs 20.6 per 100,000 doses). The replacement resulted in a decline in the number of reports and AEFI reporting rates, most notably a substantial decrease in injection site reactions.
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, Canada M5G 1V2. Electronic address: Salman.Klar@oahpp.ca.
authors.forename: Salman
authors.initials: S
authors.lastname: Klar
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, Canada M5G 1V2. Electronic address: tara.harris@oahpp.ca.
authors.forename: Tara
authors.initials: T
authors.lastname: Harris
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, Canada M5G 1V2. Electronic address: kenny.wong@oahpp.ca.
authors.forename: Kenny
authors.initials: K
authors.lastname: Wong
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, Canada M5G 1V2. Electronic address: jill.fediurek@oahpp.ca.
authors.forename: Jill
authors.initials: J
authors.lastname: Fediurek
authors.affiliation: Public Health Ontario, 480 University Avenue, Suite 300, Toronto, ON, Canada M5G 1V2; Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, Canada M5T 3M7. Electronic address: shelley.deeks@oahpp.ca.
authors.forename: Shelley L
authors.initials: SL
authors.lastname: Deeks
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D002648:Child; D002675:Child, Preschool; D015721:Diphtheria-Tetanus-Pertussis Vaccine / Q000008:administration & dosage / Q000009:adverse effects; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000008:administration & dosage* / Q000009:adverse effects; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D006801:Humans; D017589:Immunization Programs; D007117:Immunization, Secondary / Q000009:adverse effects*; D009864:Ontario / Q000453:epidemiology; D011054:Poliovirus Vaccine, Inactivated / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: C505143:Boostrix; D015721:Diphtheria-Tetanus-Pertussis Vaccine; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D011054:Poliovirus Vaccine, Inactivated; C509326:adacel
keywords: AEFI; Adverse effects; Diphtheria–tetanus–acellular pertussis vaccines; Safety