Disease Control and Prevention Center, National Center for Global Health and Medicine, Japan.
Department of Hygiene, Public Health and Preventive Medicine, Showa University School of Medicine, Japan.
Jpn J Infect Dis. 2021 Sep 22;74(5):399-404. doi: 10.7883/yoken.JJID.2020.947. Epub 2021 Jan 29.
Tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine is generally used for booster vaccination of infants in Europe and the United States to avoid increased reactogenicity after diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccination. However, Japan has extended the use of additional DTaP vaccination without reducing the antigen dose for diphtheria and pertussis in adolescents and adults, despite limited reports on its safety in adults. This prospective, observational, questionnaire-based study investigated the occurrence of adverse events (AEs) following DTaP vaccination between June 2018 and June 2019 in participants aged 10 years or older. Of the 250 eligible participants, 235 (94%) responded regarding AEs. Among them, 133 (56.6%) reported AEs, of which 39 reported systemic AEs (16.6%) and 120 reported local AEs (51.1%) attributed to DTaP vaccination. The incidence of local AEs was markedly higher with DTaP vaccination than with non-DTaP vaccination (51.1% vs. 10.5%), and AEs appeared later (P < 0.01) and lasted longer (P < 0.01) with DTaP vaccination. However, more than 75% of these AEs resolved within 7 days. DTaP vaccination was not associated with any serious AEs. These results indicate that the DTaP vaccine can be widely used as a booster in adults as an alternative to the Tdap vaccine.
破伤风类毒素、白喉类毒素和无细胞百日咳（Tdap）疫苗通常用于欧洲和美国的婴儿加强免疫接种，以避免白喉和破伤风类毒素和无细胞百日咳（DTaP）疫苗接种后反应原性增加。然而，尽管有关成人安全性的报告有限，日本仍将 DTaP 疫苗接种的用途扩展到青少年和成人，而不减少白喉和百日咳的抗原剂量。本前瞻性、观察性、基于问卷的研究调查了 2018 年 6 月至 2019 年 6 月期间 10 岁及以上参与者接受 DTaP 疫苗接种后不良事件（AE）的发生情况。在 250 名符合条件的参与者中，有 235 名（94%）对 AE 做出了回应。在他们中，有 133 名（56.6%）报告了 AE，其中 39 名报告了全身 AE（16.6%），120 名报告了局部 AE（51.1%）归因于 DTaP 疫苗接种。与非 DTaP 疫苗接种相比，DTaP 疫苗接种后局部 AE 的发生率明显更高（51.1% vs. 10.5%），且 DTaP 疫苗接种后出现的时间较晚（P < 0.01），持续时间更长（P < 0.01）。然而，这些 AE 中有超过 75%在 7 天内得到解决。DTaP 疫苗接种与任何严重 AE 无关。这些结果表明，DTaP 疫苗可作为成人加强免疫的广泛替代品，替代 Tdap 疫苗。
