Return to Abstract Index
Title
Adverse events following pertussis and rubella vaccines. Summary of a report of the Institute
of Medicine.
AuthorHowson CP; Fineberg HV
AddressInstitute of Medicine, National Academy of Sciences, Washington, DC 20418.
Source
JAMA,
267:
3, 1992 Jan 15,
392-6
AbstractIn August 1991, the Institute of Medicine released a report entitled Adverse Effects of Pertussis
and Rubella Vaccines, which examined 18 adverse events in relation to diphtheria-tetanus-pertussis (DTP)
vaccine and four adverse events in relation to the currently used rubella vaccine strain, RA 27/3. The
committee spent 20 months reviewing a wide range of information sources, including case series and
individual case reports, both published and unpublished, epidemiologic studies, studies in animals, and
other laboratory studies. The committee found that the evidence indicates a causal relation between
DTP vaccine and anaphylaxis and between the pertussis component of DTP vaccine and extended periods of
inconsolable crying or screaming. The committee also reported that the evidence indicates a causal
relation between the rubella vaccine and acute arthritis in adult women. The committee found the available
evidence weaker but still consistent with a causal relation between DTP vaccine and two conditions--acute
encephalopathy and hypotonic, hyporesponsive episodes--and between rubella vaccine and chronic arthritis
in adult women. Estimated incidence rates of these adverse events following vaccination are provided,
where possible. The committee found that the evidence does not indicate a causal relation between the
DTP vaccine and infantile spasms, hypsarrhythmia, Reye's syndrome, and sudden infant death syndrome.
The committee found insufficient evidence to indicate either the presence or absence of a causal relation
between DTP vaccine and chronic neurologic damage, aseptic meningitis, erythema multiforme or other
rash, Guillain-Barré syndrome, hemolytic anemia, juvenile diabetes, learning disabilities and attention-deficit
disorder, peripheral mononeuropathy, or thrombocytopenia, and between rubella vaccine and
radiculoneuritis and other neuropathies or thrombocytopenic purpura. The committee's evaluative methods
are briefly described and a summary of research needs is provided.