DÄ internationalArchive41/2011The Timing of the Vaccination Is Important
LNSLNS

When reading an article that gives unqualified praise to “protective vaccinations” in the first sentence one cannot help but doubt the authors’ objectivity. The conclusion in the abstract—that no differences have been observed with regard to allergic disorders—also raises skepticism, since unvaccinated subjects in two of the three age groups under investigations tendentially showed fewer infections and atopic disorders than those who were vaccinated, and none of the unvaccinated children younger than 10 had developed asthma. The lack of statistical significance may be due to the low number of unvaccinated subjects included, which means that a credible statement about the risk of allergies is altogether impossible.

Another limitation of the article is the undifferentiated inclusion into the “vaccinated” group of all children who were vaccinated at some point in their lives. In order to determine adverse effects of vaccinations on the immune system it would seem that the timing of the vaccination is the crucial factor—which, in the past decades, has continually been brought forward. These days, entire conferences are dedicated to the negative effects of early vaccination on the immune system (1). A large-scale Canadian study found more than double the risk of asthma in 7-year-olds who were vaccinated in the 3rd month of their lives compared with those who were vaccinated after the 5th month (2).

A further limitation is the lack of differentiation by number and type of vaccinations. Measles and pertussis vaccinations affect the immune system in very different ways. The working group around Bernsen cited by Schmitz published a study in 2008 in which children vaccinated against pertussis were confirmed to have an increased risk of allergies when they finally did contract pertussis after all. Mascart described in details the long-term cytokine changes after pertussis vaccination in very young infants (3).

DOI: 10.3238/arztebl.2011.0696a

Dr. med. Martin Hirte, München

martin.hirte@t-online.de

Dr. med. Steffen Rabe, München

Georg Soldner, München

Dr. med Stefan Schmidt-Troschke, Herdecke

Conflict of interest statement
The authors declare that no conflict of interest exists.

1.
Flanagan KL, et al.: Sex differences in the vaccine-specific and non-targeted effects of vaccines. Vaccine 2011; 29(13): 2349–54. CrossRef MEDLINE
2.
McDonald KL, Huq SI, Lix LM, Becker AB, Kozyrskyj AL: Delay in diphtheria, pertussis, tetanus vaccination is associated with a re-duced risk of childhood asthma. J Allergy Clin Immunol 2008; 121(3): 626–31. CrossRef MEDLINE
3.
Mascart F, et al.: Modulation of the infant immune responses by the first pertussis vaccine administrations. Vaccine 2007; 25(2): 391–8. CrossRef MEDLINE
4.
Schmitz R, Poethko-Müller C, Reiter S, Schlaud M: Vaccination status and health in children and adolescents—findings of the German health interview and examination survey for children and adolescents (KiGGS). Dtsch Arztebl Int 2011; 108(7): 99–104. VOLLTEXT
1.Flanagan KL, et al.: Sex differences in the vaccine-specific and non-targeted effects of vaccines. Vaccine 2011; 29(13): 2349–54. CrossRef MEDLINE
2.McDonald KL, Huq SI, Lix LM, Becker AB, Kozyrskyj AL: Delay in diphtheria, pertussis, tetanus vaccination is associated with a re-duced risk of childhood asthma. J Allergy Clin Immunol 2008; 121(3): 626–31. CrossRef MEDLINE
3.Mascart F, et al.: Modulation of the infant immune responses by the first pertussis vaccine administrations. Vaccine 2007; 25(2): 391–8. CrossRef MEDLINE
4.Schmitz R, Poethko-Müller C, Reiter S, Schlaud M: Vaccination status and health in children and adolescents—findings of the German health interview and examination survey for children and adolescents (KiGGS). Dtsch Arztebl Int 2011; 108(7): 99–104. VOLLTEXT