Timeliness of DTaP-IPV-Hib Vaccination and Development of Atopic Dermatitis Between 4 Months and 1 Year of Age—Register-Based Cohort Study

Lise Gehrt*, Andreas Rieckmann, Nicholas Kiraly, Aksel Karl Georg Jensen, Peter Aaby, Christine Stabell Benn, Signe Sørup

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Background: An Australian study including 4433 children found that delayed Diphtheria-Tetanus-acellular Pertussis–containing vaccination was associated with reduced risk of developing atopic dermatitis (AD) before age 1 year. Objective: We assessed whether delayed vaccination against diphtheria, tetanus, acellular pertussis, polio, and Haemophilus influenzae type b (Diphtheria, Tetanus, acellular Pertussis – Inactivated Polio vaccine – Haemophilus influenzae type b [DTaP]) was associated with a reduced risk of new cases of AD before age 1 year in Denmark. Methods: We used nationwide registers to follow 883,160 children born in Denmark from 1997 to 2012. Binary regression models adjusting for potential confounding factors were applied to estimate relative risks (adjusted relative risks [aRRs]) of developing AD among children with delayed DTaP vaccination (defined as given 1 month or more after the recommended age) compared with timely vaccinated children. Results: Among 143,429 children with a delayed first dose of DTaP, 4,847 (3.4%) developed AD between age 4 months and 1 year, compared with 27,628 (3.7%) among 739,731 children not having delayed DTaP (aRR 0.94; 95% CI, 0.91-0.97). The aRR was 0.94 (95% CI, 0.90-0.99) for children with a delayed second dose, and the aRR was 0.88 (95% CI, 0.82-0.93) when comparing children with delayed first and second doses with all timely vaccinated children. Conclusions: The results support the hypothesis that delayed vaccination with DTaP is associated with reduced risk of developing new cases of AD after age 4 months. The dose-dependent relationship strengthens the evidence of a causal relationship. Some countries are introducing maternal pertussis vaccination and delaying the first dose of DTaP, providing a possibility for further testing the hypothesis.

Original languageEnglish
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume9
Issue number4
Pages (from-to)1520-1528
ISSN2213-2198
DOIs
Publication statusPublished - Apr 2021

Keywords

  • Atopic dermatitis
  • Diphtheria, Tetanus, acellular Pertussis – Inactivated Polio vaccine – Haemophilus influenzae type b vaccine
  • Eczema
  • Non-specific effects of vaccines

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