Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. e367-e373 (doi:10.1542/peds.2006-1479)
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ARTICLE

Diphtheria, Pertussis, Poliomyelitis, Tetanus, and Haemophilus influenzae Type b Vaccinations and Risk of Eczema and Recurrent Wheeze in the First Year of Life: The KOALA Birth Cohort Study

Ischa Kummeling, MSca, Carel Thijs, MD, PhDa, Foekje Stelma, MD, PhDb, Macheld Huber, MDc, Piet A. van den Brandt, PhDa and Pieter C. Dagnelie, PhDa

a Department of Epidemiology, Maastricht University, Maastricht, Netherlands
b Department of Medical Microbiology, University Hospital of Maastricht, Maastricht, Netherlands
c Louis Bolk Institute, Driebergen, Netherlands

OBJECTIVES. Among potential etiologic factors for atopic manifestations, infant vaccinations have recently been discussed. We evaluated in a prospective design whether infants who were unvaccinated or vaccinated according to incomplete vaccination schedules in the first 6 months of age were at decreased risk for eczema and recurrent wheeze in the first year of life.

METHODS. Information on vaccinations against diphtheria, pertussis, poliomyelitis, tetanus; Haemophilus influenzae type b vaccine; and eczema and recurrent wheeze was collected by repeated questionnaires in 2764 families participating in the KOALA Birth Cohort Study in the Netherlands. A standard vaccination schedule referred to 3 diphtheria, pertussis, poliomyelitis, tetanus, and Haemophilus influenzae type b vaccinations in the first 6 months with the first given in months 1 to 3; an incomplete vaccination schedule was defined as any other vaccination schedule. Exclusion criteria were prematurity (gestational age <37 weeks) and congenital abnormalities related to immunity (such as Down syndrome). Multiple logistic regression models were fitted to adjust for confounding factors.

RESULTS. During the first year of life, the incidence of eczema was 23% (584 of 2537 infants) and of recurrent wheeze, the incidence was 8.5% (203 of 2402 infants). At age 6 months, 1969 (77%) of 2545 infants had been vaccinated according to a standard schedule, 393 (15%) vaccinated according to an incomplete schedule, and 182 (7%) never vaccinated. Compared with infants with standard vaccination schedules, infants with incomplete schedules did not differ significantly in eczema risk or recurrent wheeze. This was also true for infants who had never been vaccinated.

CONCLUSION. This study shows that the risk of eczema or recurrent wheeze at 1 year of age does not differ between infants with different vaccination status at the age of 6 months.

Key Words: vaccinations • birth cohort • infants • eczema • recurrent wheeze

Abbreviations: DPPT—diphtheria, pertussis, poliomyelitis, tetanus • Hib—Haemophilus influenzae type b • ETS—environmental tobacco smoke • OR—odds ratio • CI—confidence interval • IgE—immunoglobulin E • DPT—diphtheria, pertussis, tetanus

Accepted Aug 16, 2006.


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