Baraff L J, Cody C L, Cherry J D
Pediatrics. 1984 Jan;73(1):31-6.
Local and less serious systemic reactions are frequent following immunization with diphtheria-tetanus-pertussis (DTP) vaccine. The effects of injection site, manufacturer, previous reactions, and dosage reduction upon subsequent reactions to DTP immunization were investigated. Local reactions, notably pain and swelling, were less common when the immunization was given in the buttocks than in the thigh. No injection site was consistently associated with lower systemic reaction rates. There was no significant difference in the rate of more serious reactions by vaccine manufacturer. Differences in rates of less serious reactions by manufacturer were observed but seemed to be related to vaccine lot differences rather than the specific vaccines. In a subset of 772 children, in whom data regarding sequential reactions were available, it was noted that all three reactions investigated--local redness, temperature greater than or equal to 39 degrees C, and persistent crying longer than one-half hour--were two to three times more frequent on a subsequent immunization when present on a prior vaccination than if not present on a prior vaccination than if not present previously. One hundred children received a half dose of DTP vaccine because of a less serious reaction associated with prior immunization. In all instances, they had significantly less serious local reactions as well as notable differences in temperature, drowsiness, and persistent crying.
接种白喉-破伤风-百日咳（DTP）疫苗后，局部和不太严重的全身反应很常见。研究了注射部位、生产商、既往反应以及剂量减少对后续DTP疫苗接种反应的影响。当在臀部接种疫苗时，局部反应，尤其是疼痛和肿胀，比在大腿接种时更少见。没有一个注射部位始终与较低的全身反应率相关。疫苗生产商之间更严重反应的发生率没有显著差异。观察到生产商之间不太严重反应发生率的差异，但似乎与疫苗批次差异有关，而不是与特定疫苗有关。在772名有连续反应数据的儿童亚组中，注意到所研究的所有三种反应——局部发红、体温大于或等于39摄氏度以及持续哭闹超过半小时——如果在前一次接种时出现，那么在随后的接种中出现的频率是前一次未出现时的两到三倍。100名儿童因之前接种疫苗出现不太严重的反应而接受了半剂量的DTP疫苗。在所有情况下，他们的局部反应明显不那么严重，在体温、嗜睡和持续哭闹方面也有显著差异。
