The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine

William E. Barlow, Robert Davis, John W. Glasser, Phillip H. Rhodes, Robert S. Thompson, John P. Mullooly, Steven B. Black, Henry R. Shinefield, Joel I. Ward, S. Michael Marcy, Frank Destefano, Virginia Immanuel, John A. Pearson, Constance M. Vadheim, Viviana Rebolledo, Dimitri Christakis, Patti J. Benson, Ned Lewis, Robert T. Chen

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215 Citations (Scopus)

Abstract

Background: The administration of the diphtheria and tetanus toxoids and whole-cell pertussis (DTP) vaccine and measles, mumps, and rubella (MMR) vaccine has been associated with seizures. We studied the relation between these vaccinations and the risk of a first seizure, subsequent seizures, and neurodevelopmental disability in children. Methods: This cohort study was conducted at four large health maintenance organizations and included reviews of the medical records of children with seizures. We calculated the relative risks of febrile and nonfebrile seizures among 679,942 children after 340,386 vaccinations with DTP vaccine, 137,457 vaccinations with MMR vaccine, or no recent vaccination. Children who had febrile seizures after vaccination were followed to identify the risk of subsequent seizures and other neurologic disabilities. Results: Receipt of DTP vaccine was associated with an increased risk of febrile seizures only on the day of vaccination (adjusted relative risk, 5.70; 95 percent confidence interval, 1.98 to 16.42). Receipt of MMR vaccine was associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83;, 95 percent confidence interval, 1.44 to 5.55). Neither vaccination was associated with an increased risk of nonfebrile seizures. The number of febrile seizures attributable to the administration of DTP and MMR vaccines was estimated to be 6 to 9 and 25 to 34 per 100,000 children, respectively. As compared with other children with febrile seizures that were not associated with vaccination, the children who had febrile seizures after vaccination were not found to be at higher risk for subsequent seizures or neurodevelopmental disabilities. Conclusions: There are significantly elevated risks of febrile seizures after receipt of DTP vaccine or MMR vaccine, but these risks do not appear to be associated with any long-term, adverse consequences.

Original languageEnglish (US)
Pages (from-to)656-661
Number of pages6
JournalNew England Journal of Medicine
Volume345
Issue number9
DOIs
StatePublished - Aug 30 2001

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Measles-Mumps-Rubella Vaccine
Whooping Cough
Febrile Seizures
Seizures
Vaccination
Diphtheria-Tetanus-Pertussis Vaccine
Confidence Intervals
Diphtheria Toxoid
Pertussis Vaccine
Tetanus Toxoid
Health Maintenance Organizations
Nervous System
Medical Records
Cohort Studies

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Barlow, W. E., Davis, R., Glasser, J. W., Rhodes, P. H., Thompson, R. S., Mullooly, J. P., ... Chen, R. T. (2001). The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. New England Journal of Medicine, 345(9), 656-661. https://doi.org/10.1056/NEJMoa003077

The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. / Barlow, William E.; Davis, Robert; Glasser, John W.; Rhodes, Phillip H.; Thompson, Robert S.; Mullooly, John P.; Black, Steven B.; Shinefield, Henry R.; Ward, Joel I.; Michael Marcy, S.; Destefano, Frank; Immanuel, Virginia; Pearson, John A.; Vadheim, Constance M.; Rebolledo, Viviana; Christakis, Dimitri; Benson, Patti J.; Lewis, Ned; Chen, Robert T.

In: New England Journal of Medicine, Vol. 345, No. 9, 30.08.2001, p. 656-661.

Research output: Contribution to journalArticle

Barlow, WE, Davis, R, Glasser, JW, Rhodes, PH, Thompson, RS, Mullooly, JP, Black, SB, Shinefield, HR, Ward, JI, Michael Marcy, S, Destefano, F, Immanuel, V, Pearson, JA, Vadheim, CM, Rebolledo, V, Christakis, D, Benson, PJ, Lewis, N & Chen, RT 2001, 'The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine', New England Journal of Medicine, vol. 345, no. 9, pp. 656-661. https://doi.org/10.1056/NEJMoa003077
Barlow, William E. ; Davis, Robert ; Glasser, John W. ; Rhodes, Phillip H. ; Thompson, Robert S. ; Mullooly, John P. ; Black, Steven B. ; Shinefield, Henry R. ; Ward, Joel I. ; Michael Marcy, S. ; Destefano, Frank ; Immanuel, Virginia ; Pearson, John A. ; Vadheim, Constance M. ; Rebolledo, Viviana ; Christakis, Dimitri ; Benson, Patti J. ; Lewis, Ned ; Chen, Robert T. / The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine. In: New England Journal of Medicine. 2001 ; Vol. 345, No. 9. pp. 656-661.
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abstract = "Background: The administration of the diphtheria and tetanus toxoids and whole-cell pertussis (DTP) vaccine and measles, mumps, and rubella (MMR) vaccine has been associated with seizures. We studied the relation between these vaccinations and the risk of a first seizure, subsequent seizures, and neurodevelopmental disability in children. Methods: This cohort study was conducted at four large health maintenance organizations and included reviews of the medical records of children with seizures. We calculated the relative risks of febrile and nonfebrile seizures among 679,942 children after 340,386 vaccinations with DTP vaccine, 137,457 vaccinations with MMR vaccine, or no recent vaccination. Children who had febrile seizures after vaccination were followed to identify the risk of subsequent seizures and other neurologic disabilities. Results: Receipt of DTP vaccine was associated with an increased risk of febrile seizures only on the day of vaccination (adjusted relative risk, 5.70; 95 percent confidence interval, 1.98 to 16.42). Receipt of MMR vaccine was associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83;, 95 percent confidence interval, 1.44 to 5.55). Neither vaccination was associated with an increased risk of nonfebrile seizures. The number of febrile seizures attributable to the administration of DTP and MMR vaccines was estimated to be 6 to 9 and 25 to 34 per 100,000 children, respectively. As compared with other children with febrile seizures that were not associated with vaccination, the children who had febrile seizures after vaccination were not found to be at higher risk for subsequent seizures or neurodevelopmental disabilities. Conclusions: There are significantly elevated risks of febrile seizures after receipt of DTP vaccine or MMR vaccine, but these risks do not appear to be associated with any long-term, adverse consequences.",
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T1 - The risk of seizures after receipt of whole-cell pertussis or measles, mumps, and rubella vaccine

AU - Barlow, William E.

AU - Davis, Robert

AU - Glasser, John W.

AU - Rhodes, Phillip H.

AU - Thompson, Robert S.

AU - Mullooly, John P.

AU - Black, Steven B.

AU - Shinefield, Henry R.

AU - Ward, Joel I.

AU - Michael Marcy, S.

AU - Destefano, Frank

AU - Immanuel, Virginia

AU - Pearson, John A.

AU - Vadheim, Constance M.

AU - Rebolledo, Viviana

AU - Christakis, Dimitri

AU - Benson, Patti J.

AU - Lewis, Ned

AU - Chen, Robert T.

PY - 2001/8/30

Y1 - 2001/8/30

N2 - Background: The administration of the diphtheria and tetanus toxoids and whole-cell pertussis (DTP) vaccine and measles, mumps, and rubella (MMR) vaccine has been associated with seizures. We studied the relation between these vaccinations and the risk of a first seizure, subsequent seizures, and neurodevelopmental disability in children. Methods: This cohort study was conducted at four large health maintenance organizations and included reviews of the medical records of children with seizures. We calculated the relative risks of febrile and nonfebrile seizures among 679,942 children after 340,386 vaccinations with DTP vaccine, 137,457 vaccinations with MMR vaccine, or no recent vaccination. Children who had febrile seizures after vaccination were followed to identify the risk of subsequent seizures and other neurologic disabilities. Results: Receipt of DTP vaccine was associated with an increased risk of febrile seizures only on the day of vaccination (adjusted relative risk, 5.70; 95 percent confidence interval, 1.98 to 16.42). Receipt of MMR vaccine was associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83;, 95 percent confidence interval, 1.44 to 5.55). Neither vaccination was associated with an increased risk of nonfebrile seizures. The number of febrile seizures attributable to the administration of DTP and MMR vaccines was estimated to be 6 to 9 and 25 to 34 per 100,000 children, respectively. As compared with other children with febrile seizures that were not associated with vaccination, the children who had febrile seizures after vaccination were not found to be at higher risk for subsequent seizures or neurodevelopmental disabilities. Conclusions: There are significantly elevated risks of febrile seizures after receipt of DTP vaccine or MMR vaccine, but these risks do not appear to be associated with any long-term, adverse consequences.

AB - Background: The administration of the diphtheria and tetanus toxoids and whole-cell pertussis (DTP) vaccine and measles, mumps, and rubella (MMR) vaccine has been associated with seizures. We studied the relation between these vaccinations and the risk of a first seizure, subsequent seizures, and neurodevelopmental disability in children. Methods: This cohort study was conducted at four large health maintenance organizations and included reviews of the medical records of children with seizures. We calculated the relative risks of febrile and nonfebrile seizures among 679,942 children after 340,386 vaccinations with DTP vaccine, 137,457 vaccinations with MMR vaccine, or no recent vaccination. Children who had febrile seizures after vaccination were followed to identify the risk of subsequent seizures and other neurologic disabilities. Results: Receipt of DTP vaccine was associated with an increased risk of febrile seizures only on the day of vaccination (adjusted relative risk, 5.70; 95 percent confidence interval, 1.98 to 16.42). Receipt of MMR vaccine was associated with an increased risk of febrile seizures 8 to 14 days after vaccination (relative risk, 2.83;, 95 percent confidence interval, 1.44 to 5.55). Neither vaccination was associated with an increased risk of nonfebrile seizures. The number of febrile seizures attributable to the administration of DTP and MMR vaccines was estimated to be 6 to 9 and 25 to 34 per 100,000 children, respectively. As compared with other children with febrile seizures that were not associated with vaccination, the children who had febrile seizures after vaccination were not found to be at higher risk for subsequent seizures or neurodevelopmental disabilities. Conclusions: There are significantly elevated risks of febrile seizures after receipt of DTP vaccine or MMR vaccine, but these risks do not appear to be associated with any long-term, adverse consequences.

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