Outcome Measures



Contribution to Causality Argument


(1.57-3.78)/2.22 (1.30-3.77)

Any allergy-related respiratory symptom (past 12 mos) = 1.68 (1.09-2.59)/1.63 (1.05-2.54)

Any lifetime allergy history/12 mo. Symptoms = 1.79 (1.16-2.76)/1.69 (1.10-2.59)



Farooqi & Hopkin (1998)


1934 patients born in 1975- 1984 (United Kingdom)

DTwP/DT, polio, measles immunization from regional Child Health database

Clinical diagnosis of allergic disorder (eczema, hay fever, or asthma).

Unadjusted OR for DTwP immunization (either complete or incomplete course) (95%CI)

Allergy = 1.57 (1.28-1.95);

Asthma = 1.44 (1.17-1.85),

Hay fever = 1.56 (1.21-2.02).

Multiple logistic regression: pertussis immunization

Allergic disorders = 1.76 (1.39- 2.23)

Potential health care-seeking bias; exclusion of 36% of potential subjects.

Weak evidence relevant to causality. Favors effect of pertussis component of DTwP

Nilsson et al. (1998)

Randomized controlled trial

669 children participating in pertussis vaccine trial (Sweden)

Randomization to DTaP (2- or 5-component), DTwP, and DT given at 2 months. All children were given Hib and inactivated polio virus. Children followed for 2.5 years

Diagnosis based on questionaires, clinical findings, and information on medical records for bronchial asthma, atopic dermatitis, allergic rhinitis, urticaria, and food allergy

Estimated increase in risk:

No parental history of allergic disease (one-sided 95% CI):

DTwP = 8% reduction (28% increase)

DTaP = 10% increase (41% increase)

Both parents had history of allergic disease

DTwP = 6% reduction (18% increase)

DTaP = 8% increase (27% increase)

Differences non-significant; one-tailed analysis; wide confidence intervals; restriction to development before 2.5 years of age, and focus only on pertussis component of immunization schedule.

Weak evidence relevant to causality. Favors no effect of DTaP

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