The impact of DTaP-IPV-HB vaccine on use of health services for young infants.
Pediatr Infect Dis J
; 25(9): 826-31, 2006 Sep.
Article
en En
| MEDLINE
| ID: mdl-16940842
ABSTRACT
BACKGROUND:
In 2003, a pentavalent vaccine (diphtheria, tetanus and acellular pertussis, injectable polio and hepatitis B) was introduced into the childhood vaccination schedule. A premarketing study showed a higher incidence of fever than with the vaccines administered separately. Because fevers in young infants prompt medical evaluations, this study examines the impact of this vaccine (DTaP-IPV-HB) on subsequent use of health services.METHODS:
We compared use of health services among 6- to 10-week-old infants receiving DTaP-IPV-HB (n = 1776) with a historical control receiving the prior schedule (n = 2162) at an inner-city practice network. Data sources included a hospital immunization registry and medical records. Outcome measures were visits to the emergency department and ambulatory practices, fever, tests, antibiotics and hospitalizations. Outcomes were stratified by age (<8, 8-10 weeks) and days since vaccination (3, 7).RESULTS:
Infants vaccinated with DTaP-IPV-HB were more likely to visit the ED (1.2% versus 0.6%, P = 0.03) and receive tests (47.6% versus 8.3%, P = 0.03) within 3 days of vaccination compared with the controls. Multivariate analysis showed infants vaccinated with DTaP-IPV-HB had a 7-fold increased risk of receiving a full sepsis workup and a 3-fold increased risk of receiving antibiotics within 7 days of vaccination. Medical evaluations decreased over time after implementation of the DTaP-IPV-HB vaccine. Concurrently, the rate of vaccination for infants <8 weeks markedly dropped.CONCLUSIONS:
The DTaP-IPV-HB vaccine was associated with increased use of health services in the emergency department, but these associations lessened over time. These findings reveal a conflict between the obligation of timely and efficient vaccination with the medical management of febrile young infants.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Vacuna Antipolio de Virus Inactivados
/
Vacunación
/
Vacunas contra Hepatitis B
/
Vacunas contra Difteria, Tétanos y Tos Ferina Acelular
Tipo de estudio:
Etiology_studies
Límite:
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Pediatr Infect Dis J
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
/
PEDIATRIA
Año:
2006
Tipo del documento:
Article
País de afiliación:
Estados Unidos