Maitra A, Sherriff A, Griffiths M, Henderson J; Avon Longitudinal Study of Parents and Children Study Team. BMJ. 2004;328:925–926
Purpose of the Study.
To examine the association of pertussis vaccination in infancy to asthma or atopy by the age of 7.5 years.
A population-based birth cohort of 13 971 children who survived to 1 year in the Avon Longitudinal Study of Parents and Children.
Vaccination status for each child from the child health surveillance was obtained. Children were categorized as fully vaccinated (primary course of diphtheria, tetanus, and pertussis vaccines), partially vaccinated (completed primary course of diphtheria and tetanus vaccines but did not receive pertussis vaccine), or nonvaccinated. Wheeze outcomes were parental report of asthma at age 69 to 81 months, wheeze with whistling in the chest at age 69 to 81 months, and asthma diagnosed by a doctor at 91 months. A positive outcome of atopy was defined by any positive allergy skin tests at 7 years old. Multivariable logistic regression was used to evaluate associations between immunization status and asthma and allergy outcomes.
Vaccination history was available for 13 810 children: 13 109 (94.9%) were fully vaccinated, and 1446 did not have pertussis vaccination (340 nonvaccinated; 106 partially vaccinated). Prevalence of reported asthma at age 69 to 81 months was 12.4%, reported wheeze with whistling at 69 to 81 months was 9.8%, and atopy at 7 years was 20.5%. Unadjusted analyses showed significant associations between partial vaccination and asthma at age 69 to 81 months (odds ratio [OR]: 2.84; 95% confidence interval [CI]: 1.24, 6.53) and doctor-diagnosed asthma (OR: 3.03; 95% CI: 1.51, 6.09), but these associations did not remain in multivariate analysis. In multivariate analyses, there were no significant associations between the vaccinated categories and any of the outcomes.
There is lack of an independent association between pertussis vaccination in infancy and inactivated, whole-cell vaccine and the subsequent development of asthma or atopy during later childhood.
This is a nice study evaluating whether there is an association between pertussis vaccination in infancy and the development of asthma or allergy in a large birth cohort. The lack of association by multivariate analysis agrees with some of the more recent studies that have looked at cross-sectional or earlier childhood outcomes. The results of this study in older children are encouraging and provide additional evidence that the benefits of vaccination far outweigh any risks.