To the Editor.—
The recent article by Funkhouser et al1 focuses on one alternative to the present immunization schedule recommended in the United States for diphtheria and tetanus toxoids and pertussis vaccine (DTP). The analysis utilizes a host of assumptions and extrapolations that require substantiation and clarification. Incidence data on pertussis and adverse reactions to vaccine need further study.It is imperative at this juncture that we develop criteria for the evaluation of children with alleged temporal associations between immunizations and sequelae to develop reliable data on severe adverse reactions to DTP in the United States. A uniform system of evaluation will facilitate our understanding of true reactions to DTP.The diagnostic evaluation of such patients must recognize that many of the patients have preexisting or concurrent infections or neurological conditions that surface following the administration of the vaccine, eg, an enterovirus or Haemophilus influenzae meningitis infection. Such an
Barkin RM, Jabhour JT, Samuelson JS. Immunizations, Seizures, and Subsequent Evaluation. JAMA. 1987;258(2):201. doi:10.1001/jama.1987.03400020043012
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