Stetler H C, Orenstein W A, Bart K J, Brink E W, Brennan J P, Hinman A R
J Pediatr. 1985 Aug;107(2):175-9. doi: 10.1016/s0022-3476(85)80120-7.
Data on 2062 reports from the Monitoring System for Adverse Events Following Immunization, Centers for Disease Control (CDC), were analyzed to compare the risk of a personal or family history of convulsions in children who had a neurologic adverse event after receipt of diphtheria-tetanus-pertussis (DTP) vaccine with those who had a nonneurologic adverse event. Children with a neurologic event after DTP vaccine had a 7.2 times higher risk for personal history of convulsions (95% confidence limits 4.5 to 11.5) and a 4.5 times higher risk for family history of convulsions (95% confidence limits 3.1 to 6.7) than did children with an adverse event that did not affect the nervous system. Children with either a febrile or nonfebrile convulsion after receipt of DTP were significantly more likely to have a personal history of convulsions than children with a nonneurologic adverse event (P less than 0.0001). Children with a febrile convulsion after receipt of DTP but not children with nonfebrile convulsions were significantly more likely to have a family history of convulsions than those with a nonneurologic adverse event. It is recommended that pertussis vaccination be deferred in children with a personal history of a convulsion until it can be determined that an evolving neurologic disorder is not present. If such disorders are found, these children should be given the combined pediatric diphtheria and tetanus toxoids (DT) vaccine to complete the series.
对疾病控制中心（CDC）免疫接种后不良事件监测系统的2062份报告数据进行了分析，以比较接种白喉-破伤风-百日咳（DTP）疫苗后出现神经系统不良事件的儿童与出现非神经系统不良事件的儿童发生个人或家族惊厥病史的风险。接种DTP疫苗后出现神经系统事件的儿童，其个人惊厥病史的风险比未影响神经系统的不良事件儿童高7.2倍（95%置信区间为4.5至11.5），家族惊厥病史的风险高4.5倍（95%置信区间为3.1至6.7）。接种DTP疫苗后出现发热性或非发热性惊厥的儿童，其个人惊厥病史的可能性显著高于出现非神经系统不良事件的儿童（P小于0.0001）。接种DTP疫苗后出现发热性惊厥的儿童，而非非发热性惊厥的儿童，其家族惊厥病史的可能性显著高于出现非神经系统不良事件的儿童。建议有个人惊厥病史的儿童推迟接种百日咳疫苗，直到确定不存在正在发展的神经系统疾病。如果发现此类疾病，应给这些儿童接种联合小儿白喉和破伤风类毒素（DT）疫苗以完成接种系列。
