SIMULTANEOUS ADMINISTRATION OF A DIPHTHERIA AND TETANUS TOXOIDS AND ACELLULAR PERTUSSIS-VACCINE WITH MEASLES-MUMPS-RUBELLA AND ORAL POLIOVIRUS VACCINES

Objective.-To compare the safety and immunogenicity of Lederle Laborat ories' (Pearl River, NY) diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine with diphtheria and tetanus toxoids and whole -cell pertussis (DTwP) vaccine when administered simultaneously with m easles-mumps-rubella (MMR) vaccine and trivalent oral poliovirus (OPV) vaccine at 15 to 16 months of age. Design.-Randomized and double-blin d. Setting.-Two general pediatric practices. Participants.-Ninety-seve n infants, aged 15 to 16 months, who had received three previous DTwP immunizations. Selection Procedures and Interventions.-Healthy childre n received the DTaP or DTwP vaccine. Infants received the MMR vaccine at a separate site and the OPV vaccine concurrently. Blood was obtaine d on day 0 and at 6 weeks. Adverse events were recorded by parents at specified times after immunization. Measurements/Results.-Within 3 day s of immunization, DTaP vaccine recipients had less fever, drowsiness, and irritability (P=.01, .04, .01, respectively). They also experienc ed less tenderness, erythema, and induration (.001, .001, and .002, re spectively). There was no difference in the frequency of adverse react ions 6 to 14 days after immunization. Enzyme-linked immunosorbent assa ys were used to determine all antibody values. Antibody responses to f ilamentous hemagglutinin and pertussis toxoid were significantly great er in the DTaP group (P=.0001 and .02, respectively). Immune responses to the other measured antigens were similar. Conclusions.-Simultaneou s administration of the Lederle DTaP with MMR and OPV vaccines did not interfere with antibody response to pertussis antigens measured or me asles, mumps, or rubella viruses and was associated with fewer local a nd systemic adverse events during the first 3 days following immunizat ion when compared with the simultaneous administration of the DTwP, OP V, and MMR vaccines. We conclude that the DTaP vaccine can be administ ered at 15 months of age concurrently with the MMR and OPV vaccines.