Delay in diphtheria, pertussis, tetanus vaccination is associated with a reduced risk of childhood asthma

Background

Early childhood immunizations have been viewed as promoters of asthma development by stimulating a T_H2-type immune response or decreasing microbial pressure, which shifts the balance between T_H1 and T_H2 immunity.

Objective

Differing time schedules for childhood immunizations may explain the discrepant findings of an association with asthma reported in observational studies. This research was undertaken to determine whether timing of diphtheria, pertussis, tetanus (DPT) immunization has an effect on the development of childhood asthma by age 7 years.

Methods

This was a retrospective longitudinal study of a cohort of children born in Manitoba in 1995. The complete immunization and health care records of cohort children from birth until age 7 years were available for analysis. The adjusted odds ratio for asthma at age 7 years according to timing of DPT immunization was computed from multivariable logistic regression.

Results

Among 11, 531 children who received at least 4 doses of DPT, the risk of asthma was reduced to ½ in children whose first dose of DPT was delayed by more than 2 months. The likelihood of asthma in children with delays in all 3 doses was 0.39 (95% CI, 0.18-0.86).

Conclusion

We found a negative association between delay in administration of the first dose of whole-cell DPT immunization in childhood and the development of asthma; the association was greater with delays in all of the first 3 doses. The mechanism for this phenomenon requires further research.

Key words: DPT combination vaccine, childhood asthma, retrospective birth cohort, administrative health data

Abbreviations used: DaPT, Diphtheria, acellular pertussis, tetanus, DPT, Diphtheria, pertussis, tetanus, ICD-9, International Classification of Diseases, Ninth Revision, MIMS, Manitoba Immunization Monitoring System, MHSIP, Manitoba Health Services Insurance Program, OR, Odds ratio