PMID- 28430750
OWN - NLM
STAT- MEDLINE
DCOM- 20170918
LR  - 20170918
IS  - 1532-0987 (Electronic)
IS  - 0891-3668 (Linking)
VI  - 36
IP  - 9
DP  - 2017 Sep
TI  - Elevated Immune Response Among Children 4 Years of Age With Pronounced Local 
      Adverse Events After the Fifth Diphtheria, Tetanus, Acellular Pertussis 
      Vaccination.
PG  - e223-e229
LID - 10.1097/INF.0000000000001620 [doi]
AB  - BACKGROUND: In the Netherlands, acellular pertussis vaccines replaced the more 
      reactogenic whole-cell pertussis vaccines. This replacement in the primary 
      immunization schedule of infants coincided with a significant increase in 
      pronounced local adverse events (AEs) in 4 years old children shortly after the 
      administration of a fifth diphtheria, tetanus, acellular pertussis and 
      inactivated polio (DTaP-IPV) vaccine. The objective of this study was to 
      investigate possible differences in vaccine antigen-specific immune responses 
      between children with and without a pronounced local AE after the fifth DTaP-IPV 
      vaccination. METHODS: Blood was sampled in 2 groups of 4-year-olds: a case group 
      reporting pronounced local swelling and/or erythema up to extensive limb swelling 
      at the injection site (n = 30) and a control group (n = 30). Peripheral blood 
      mononuclear cells were stimulated with individual vaccine antigens. Plasma 
      antigen-specific IgG, IgG subclass and total IgE concentrations and T-cell 
      cytokine [interferon-gamma, interleukin (IL)-13, IL-17 and IL-10] production by 
      stimulated peripheral blood mononuclear cells were determined by multiplex 
      bead-based fluorescent multiplex immunoassays. RESULTS: In children with AEs, 
      significantly higher total IgE and vaccine antigen-specific IgG and IgG4 
      responses as well as levels of the T-helper 2 (Th2) cytokine IL-13 were found 
      after pertussis, tetanus and diphtheria stimulation compared with controls. 
      CONCLUSIONS: Children with pronounced local reactions show higher humoral and 
      cellular immune responses. Acellular vaccines are known to skew toward more Th2 
      responses. The pronounced local AEs may be associated with more Th2 skewing after 
      the fifth DTaP-IPV vaccination, but other biologic factors may also impact the 
      occurrence of these pronounced local reactions.
FAU - van der Lee, Saskia
AU  - van der Lee S
AD  - From the *Centre for Infectious Disease Control, National institute for Public 
      Health and the Environment (RIVM), Bilthoven, The Netherlands; daggerDepartment of 
      Peadiatric Immunology and Infectious Diseases, Wilhelmina Children's Hospital, 
      University Medical Center, Utrecht, The Netherlands; and double daggerNetherlands 
      Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.
FAU - Kemmeren, Jeanet M
AU  - Kemmeren JM
FAU - de Rond, Lia G H
AU  - de Rond LGH
FAU - Ozturk, Kemal
AU  - Ozturk K
FAU - Westerhof, Anneke
AU  - Westerhof A
FAU - de Melker, Hester E
AU  - de Melker HE
FAU - Sanders, Elisabeth A M
AU  - Sanders EAM
FAU - Berbers, Guy A M
AU  - Berbers GAM
FAU - van der Maas, Nicoline A T
AU  - van der Maas NAT
FAU - Rumke, Hans C
AU  - Rumke HC
FAU - Buisman, Anne-Marie
AU  - Buisman AM
LA  - eng
PT  - Clinical Trial, Phase IV
PT  - Journal Article
PL  - United States
TA  - Pediatr Infect Dis J
JT  - The Pediatric infectious disease journal
JID - 8701858
RN  - 0 (Antibodies, Bacterial)
RN  - 0 (Antigens, Bacterial)
RN  - 0 (Cytokines)
RN  - 0 (Diphtheria-Tetanus-acellular Pertussis Vaccines)
RN  - 0 (Immunoglobulin G)
SB  - IM
MH  - Antibodies, Bacterial/blood/*immunology
MH  - Antigens, Bacterial/immunology
MH  - Case-Control Studies
MH  - Cells, Cultured
MH  - Child, Preschool
MH  - Cytokines/immunology
MH  - Diphtheria-Tetanus-acellular Pertussis Vaccines/*adverse effects/*immunology
MH  - Female
MH  - Humans
MH  - Immunization, Secondary/*adverse effects/*statistics & numerical data
MH  - Immunoglobulin G/blood/immunology
MH  - Inflammation
MH  - Leukocytes, Mononuclear/immunology
MH  - Male
MH  - Netherlands/epidemiology
EDAT- 2017/04/22 06:00
MHDA- 2017/09/19 06:00
CRDT- 2017/04/22 06:00
PHST- 2017/04/22 06:00 [pubmed]
PHST- 2017/09/19 06:00 [medline]
PHST- 2017/04/22 06:00 [entrez]
AID - 10.1097/INF.0000000000001620 [doi]
PST - ppublish
SO  - Pediatr Infect Dis J. 2017 Sep;36(9):e223-e229. doi: 
      10.1097/INF.0000000000001620.