Rennels Margaret B
Center for Vaccine Development, Department of Pediatrics, University of Maryland School of Medicine, Room 480, 685 West Baltimore Street, Baltimore, MD 21201, USA.
Semin Pediatr Infect Dis. 2003 Jul;14(3):196-8. doi: 10.1016/s1045-1870(03)00033-5.
Extensive local reactions are recognized to occur after administration of the fourth and fifth booster doses of diphtheria-tetanus-acellular pertussis (DTaP) vaccines. The incidence of these reactions is being delineated by prospective studies. Retrospective evaluations suggest that entire proximal limb swelling occurs in 2 to 6 percent of children given booster doses of DTaP vaccines. The reactions subside without sequelae, but they may be misdiagnosed as cellulitis and lead to unnecessary medical intervention. The pathogenesis of these reactions probably is multifactorial. Evidence suggests that both antigen content and prevaccination immunity have roles. Important, unanswered questions are the safety of revaccinating a child who previously has had an extensive local reaction and the safety of introducing further DTaP boosters into the adolescent and adult populations.
人们认识到，在接种白喉-破伤风-无细胞百日咳（DTaP）疫苗的第四剂和第五剂加强针后，会出现广泛的局部反应。前瞻性研究正在明确这些反应的发生率。回顾性评估表明，在接种DTaP疫苗加强针的儿童中，2%至6%会出现整个近端肢体肿胀。这些反应会自行消退，不留后遗症，但可能被误诊为蜂窝织炎，从而导致不必要的医疗干预。这些反应的发病机制可能是多因素的。有证据表明，抗原含量和接种前的免疫力都起作用。重要的、尚未得到解答的问题是，对之前曾出现广泛局部反应的儿童再次接种疫苗的安全性，以及在青少年和成人人群中引入更多DTaP加强针的安全性。
