food/fluid intake, fever and respiratory embarrassment


Burstein & Fleischer (1994)


54 case children, age 3– 36 months, participating in multicenter antibiotic study and 108 age-matched controls (United States)

Vaccination history, including DTwP, obtained from medical records. Hib not yet available for these children

Children with occult bacterimia: S. pneumoniae, E. coli, S. aureus, H. influenzae, or Salmonella spp

Difference between cases and controls NS (p>0.05)

Interval (days) since last Vaccine




Interval (days) since last DTwP vaccine




Specific vaccines, other than DTwP, administered to children are unknown.; weak statistical power

Weak evidence relevant to causality; favors no effect of vaccines or of DTwP vaccine

Griffin et al. (1992)


64,591 children immunized through Tennessee county health clinics

At least one DTP vaccination in 1986 or 1987; exposure based on information in linked TN immunization-birth certificate database

Invasive bacterial infections (H. influenzae, N .meningitidis, Streptococcus pneumoniae, group B Streptococcus, or Listeria monocytogenes. in children 72 mos. or younger, from surveillance of hospital infection control

Age-adjusted RR (95% CI) Of all invasive bacterial infections by days since DTP immunization

Comparing early post-immunization periods (0–7, 8– 14, 15–28 days) to later period (29+days):

0–7 days: 1.0(0.5–2.0)

8–14 days: 0.8 (0.4–1.7)

15–28 days: 1.2(0.7–1.9)

No unvaccinated comparison group; analysis limited to cases of serious culture-confirmed cases

Weak evidence relevant to causality; favors no effect of DTP vaccine

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