Безопасность применения коклюшных вакцин у подростков

Aim: to investigate the safety of acellular pertussis vaccines for adolescents.Materials and methods. The clinical tolerability of revaccination against pertussis (cell-free component), diphtheria and tetanus was analyzed in 107 children aged 13,5–14 years. Group 1 consisted of children revaccinated with DTacP-IPV combined vaccine (Tetraxim), group 2 – vaccinated with Td and group 3 – children who received Tdap vaccine (Adacel).Results. Statistically significant differences in the frequency of local reactions between the group that received Tdap and the other two (DTacP-IPV and Td) were detected (p = 0.001and p = 0.04, respectively). Analysis of the structure of local reactions revealed a difference only in the occurrence of the hyperemia at the site of injection, with the most frequent registration in the groups of children vaccinated with DTacPIPV (29,4%) and Td (14,7%), whereas in patients vaccinated with Tdap – only in 5,9% (χ2 = 6,8 p = 0,03). Systemic reactions occurred with the same frequency in all studied groups and did not require medical correction, as well as local reactions. Thus, revaccination against pertussis, diphtheria and tetanus of adolescents using Tdap, containing the acellular pertussis component, does not exceed the frequency of systemic reactions and the number of local reactions is significantly lower in comparison with the vaccine with a reduced content of diphtheria and tetanus toxoids (Td) that is used in practice for a long time.Цель: изучение безопасности применения ацеллюлярных коклюшных вакцин у подростков.Материалы и методы. Проведен анализ клинической переносимости ревакцинации против коклюша (бесклеточный компонент), дифтерии и столбняка у 107 детей в возрасте 13,5–14 лет. 1 группу составили дети, ревакцинированные препаратом АбКДС-ИПВ (Тетраксим), 2 группу – привитые препаратом АДС-М и 3 группу – дети, получившие вакцину АбКДС-М (Адасель).Результаты. Выявлены статистически значимые различия по частоте встречаемости местных реакций между группой, получившей АбКДС-М, и двумя другими (АбКДС-ИПВ и АДС-М) (p=0,001 и p=0,04 соответственно). Анализ структуры местных реакций выявил различие показателей только по частоте возникновения гиперемии на месте инъекции, которая более часто отмечалась в группах детей, привитых АбКДС-ИПВ (29,4%) и АДС-М (14,7%), тогда как у пациентов, ревакцинированных АбКДС-М, регистрировалась только в 5,9% (χ2 =6,8 p=0,03). Системные реакции встречались с одинаковой частотой во всех исследуемых группах и не требовали медикаментозной коррекции, так же, как и местные реакции. Таким образом, ревакцинация против коклюша, дифтерии и столбняка подростков с использованием препарата АбКДС-М, содержащего бесклеточный коклюшный компонент, не вызывает повышения частоты системных реакций, а количество местных реакций достоверно ниже по сравнению с их встречаемостью при применении давно используемой на практике вакцины с уменьшенным содержанием дифтерийного и столбнячного анатоксинов АДС-М.

Safety of pertussis vaccines for adolescents

Aim: to investigate the safety of acellular pertussis vaccines for adolescents.Materials and methods. The clinical tolerability of revaccination against pertussis (cell-free component), diphtheria and tetanus was analyzed in 107 children aged 13,5–14 years. Group 1 consisted of children revaccinated with DTacP-IPV combined vaccine (Tetraxim), group 2 – vaccinated with Td and group 3 – children who received Tdap vaccine (Adacel).Results. Statistically significant differences in the frequency of local reactions between the group that received Tdap and the other two (DTacP-IPV and Td) were detected (p = 0.001and p = 0.04, respectively). Analysis of the structure of local reactions revealed a difference only in the occurrence of the hyperemia at the site of injection, with the most frequent registration in the groups of children vaccinated with DTacPIPV (29,4%) and Td (14,7%), whereas in patients vaccinated with Tdap – only in 5,9% (χ2 = 6,8 p = 0,03). Systemic reactions occurred with the same frequency in all studied groups and did not require medical correction, as well as local reactions. Thus, revaccination against pertussis, diphtheria and tetanus of adolescents using Tdap, containing the acellular pertussis component, does not exceed the frequency of systemic reactions and the number of local reactions is significantly lower in comparison with the vaccine with a reduced content of diphtheria and tetanus toxoids (Td) that is used in practice for a long time