Abstract:
:The package inserts of live viral vaccines include immunodeficiency as a contraindication. Nevertheless, patients with mild forms of immunodeficiency may benefit from vaccination. No published guidelines exist for the administration of these vaccines specifically to patients with chromosome 22q11.2 deletion syndrome. This syndrome is also sometimes called DiGeorge syndrome and is associated with thymic hypoplasia and diminished T-cell numbers and has a wide spectrum of phenotypic features that include cardiac anomalies, dysmorphic facial features, and hypocalcemia. Patients generally exhibit a mild to moderate decrement in T-cell numbers with preservation of T-cell function. The aims of this study were to investigate the incidence of side effects after live viral vaccine administration in a population with chromosome 22q11.2 deletion syndrome. The high frequency of this syndrome in the population (1:3000 children) mandates a greater understanding of the risks and benefits related to live viral vaccine administration. A retrospective analysis of vaccine adverse events was performed. The data acquisition form evaluated the frequency of live vaccine administration and the consequences of both vaccination and withholding the vaccine. Flow cytometric enumeration of T cells was performed as part of an immunologic evaluation. Thirty-two of 59 responders were vaccinated with the varicella vaccine. Only 9% of patients reported adverse events. However, 63% of unvaccinated children developed chickenpox. Comparison of patients who tolerated the vaccine with those who reported adverse events showed no statistically significant differences in current age (7 vs 5.7 years), age at vaccination (3 vs 2.5 years), or T-cell subset counts: CD3 (1951 vs 2083 cells/ microL), CD4 (1283 vs 1463 cells/ microL), and CD8 (530 vs 502 cells/ microL). Fifty-two of 59 responders were vaccinated with measles-mumps-rubella (MMR). Twelve (23%) of 52 reported mild side effects, including fever, rash, and constitutional symptoms. No severe adverse reactions were reported. No patient reported natural disease with measles, mumps, or rubella. There were no statistically significant differences between the T-cell counts in the vaccinated group reporting side effects versus the vaccinated group without side effects (mean CD3 counts: 1928 vs 1736 cells/ microL; CD4 counts: 1250 vs 1127 cells/ microL; and CD8 counts: 528 vs 483 cells/ microL). In our study, patients with chromosome 22q11.2 deletion syndrome had a similar incidence of adverse effects with varicella and MMR vaccines compared with that reported in the general population. All side effects were mild. However, in patients who did not receive the varicella vaccine, an overwhelming 63% contracted the disease. Patients who were not vaccinated against MMR did not develop natural disease. The data suggest that this is a cohort of patients with 22q11.2 deletion syndrome who have tolerated live viral vaccinations without evidence of significant side effects. A prospective study could address whether there are T-cell thresholds below which vaccination is unsafe; however, the information that we present suggests that vaccinating children with chromosome 22q11.2 deletion with live viral vaccines does not carry a significantly higher risk of adverse reactions compared with the general population, provided that they have no evidence of severe immunocompromise.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Perez EE,Bokszczanin A,McDonald-McGinn D,Zackai EH,Sullivan KEdoi
10.1542/peds.112.4.e325subject
Has Abstractpub_date
2003-10-01 00:00:00pages
e325issue
4eissn
0031-4005issn
1098-4275journal_volume
112pub_type
杂志文章相关文献
PEDIATRICS文献大全abstract::Children of substance-abusing parents, including children of alcoholics (COAs), are one of the highest risk groups of youth for substance-abuse problems. For both genetic and family environmental reasons, COAs and children of drug abusers are very vulnerable to becoming alcohol or other drug abusers.1,2 With drug use ...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVES:Incomplete subspecialty referrals, whether unscheduled or unattended, represent unmet patient needs and an opportunity to improve patient safety and experiences. Our objectives were to describe the rates of appointment scheduling and visit attendance after pediatric subspecialty referral and to examine patie...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-0545
更新日期:2019-12-01 00:00:00
abstract::Parental requests for gastrostomies, tracheostomies, or assisted ventilation in children with profound disabilities raise ethical concerns about children's interests, parental decision-making, and health care costs. The underlying concern for many relates to the perceived value of these children. Clinicians should mak...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2013-3608H
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Prevention efforts targeting adolescent risk behavior have had limited effectiveness, partly because of the reliance on individual-level interventions that do not consider the context within which behavior occurs. In addition, the role of development has not been well studied regarding its possible moderating...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-2089M
更新日期:2007-02-01 00:00:00
abstract:OBJECTIVE:Advances in medical care have led to a growing population of special needs children who are at risk for suboptimal care when they present to a physician with no previous knowledge of their medical history. This risk may be amplified in the emergency department setting when time-sensitive interventions must be...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.102.2.367
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:It has been proposed that infection by group A beta-hemolytic streptococci (GABHS) can trigger acute symptom exacerbations among patients with Tourette's syndrome (TS) or obsessive-compulsive disorder (OCD), via autoimmune mechanisms. OBJECTIVE:To examine the temporal relationship between newly acquired GAB...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.113.6.e578
更新日期:2004-06-01 00:00:00
abstract:OBJECTIVES:To describe the epidemiology of foreign-body ingestions (FBIs) of children <6 years of age who were treated in US emergency departments from 1995 to 2015. METHODS:We performed a retrospective analysis using data from the National Electronic Injury Surveillance System for children <6 years of age who were tr...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2018-1988
更新日期:2019-05-01 00:00:00
abstract:BACKGROUND:Asthma exacerbations in children are a leading cause of missed school days and health care use. Patients discharged from the hospital often do not fill discharge prescriptions and are at risk for future exacerbations. METHODS:A multidisciplinary team aimed to increase the percentage of patients discharged f...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2019-0674
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:We examined chronic conditions, functional limitations, and special health care needs in extremely preterm children (EPT; 23-25 weeks' gestation) born between 1992 and 1998 at 2 Swedish tertiary care centers that offered regional and active perinatal care to all live-born EPT infants. METHODS:Of 134 survivin...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-2215
更新日期:2017-02-01 00:00:00
abstract::Effects of phenylephrine hydrochloride on the degree of hypoxia were studied in six cyanotic patients with tetralogy of Fallot. Baseline aortic and right atrial oxygen saturations, blood gas tensions, pH, and indicator-dilution curves were obtained under stable conditions. Phenylephrine was infused while systemic arte...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND:It remains unclear if fatal brain injuries in young children are characterized by immediate rapid deterioration or can present after an initial period of lucidity. This issue has legal implications in child abuse, for which understanding the clinical course affects perpetrator identification. OBJECTIVE:To d...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2004-2671
更新日期:2005-07-01 00:00:00
abstract::Very little is known about the alcohol elimination rates of newborns who have had chronic alcohol exposure in utero. In these case reports, blood alcohol levels were taken immediately before delivery, at delivery, and postdelivery for 2 mothers who drank alcohol during their pregnancies and 3 single-birth newborns. Ne...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2011-1400
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVE:An evaluation of the opportunity to introduce fiber in the diet of weaning infants. METHODS:A descriptive review of the literature to assess the role of fiber in the following dietary interventions: (1) definition of the nutrient amounts that meet the weaning infant's physiologic needs; (2) modulation of dig...
journal_title:Pediatrics
pub_type: 杂志文章,评审
doi:
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:Meningococcal conjugate vaccination is recommended in the United States. This study evaluates the safety of quadrivalent meningococcal conjugate vaccine in a cohort aged 11 to 21 years. METHODS:This cohort study with self-controlled case-series analysis was conducted at Kaiser Permanente Southern California...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2016-2084
更新日期:2017-01-01 00:00:00
abstract::An overview and update are offered on difficulties experienced by children with monaural sensorineural deafness. It is the general consensus that children with unilateral hearing loss experience few, if any, communication and/or educational problems. The medical and educational status of a group (N = 60) of children w...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract:OBJECTIVE:To assess determinants of health care visits among children in a 12-county region of western North Carolina representative of rural areas in the United States. METHODS:Households were randomly selected for surveys of household characteristics, health status, and health care use. Surveys were conducted June 1...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.112.2.e143
更新日期:2003-08-01 00:00:00
abstract::In 1978 in the United States, 38 children aged 5 years or younger were killed when they fell from the passenger compartments of moving motor vehicles not involved in crashes. Twenty-eight children (74%) were boys. Eighteen (47%) were 2 years old; 35 (92%) were aged 1 to 3 years. Thirty-six children fell out through do...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1981-10-01 00:00:00
abstract:OBJECTIVES:With this study we aimed to compare survival rates for children with Down syndrome in 2 time periods, 1 before prenatal screening (1988-1990) and 1 contemporaneous with screening (1998-2000), and to examine the frequency of comorbidities and their influence on survival rates. METHODS:Record-linkage was perf...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2007-2840
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:It has been shown that maternal prenatal exposure to selective serotonin reuptake inhibitors (SSRIs) may be a risk factor for attention-deficit/hyperactivity disorder (ADHD) in offspring. Our goal was to examine whether paternal SSRI use before conception increases the risk of ADHD in offspring. METHODS:On ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2017-1081
更新日期:2018-01-01 00:00:00
abstract::This article reviews the literature on possible growth-suppressing effects of stimulant medications in the long-term treatment of children with the hyperkinetic behavior syndrome. The evidence clearly indicates a temporary retardation in the rate of growth in weight and suggests a temporary slowing of growth in statur...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1979-06-01 00:00:00
abstract::The presence of pulsus paradoxus (PP) in 13 episodes of status asthmaticus in 12 children, ages 13 months to 15 years, was compared sequentially to a clinical score, peak expiratory flow rate (PEFR), heart rate, arterialized capillary pH, carbon dioxide pressure (PCO2), and the ratio of inspired oxygen to oxygen press...
journal_title:Pediatrics
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00
abstract:OBJECTIVES:We tested the hypotheses that apolipoprotein E genotype, in particular carriage of the epsilon4 allele, is more likely to be associated with cerebral palsy and that children with more severe neurologic impairment are more likely to carry this allele. METHODS:In this cross-sectional study, 209 children with ...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2006-1083
更新日期:2007-02-01 00:00:00
abstract:CONTEXT:Previous studies have suggested that intervention with omega-3 long-chain polyunsaturated fatty acids (N-3 LCPUFAs), especially docosahexaenoic acid, can reduce the incidence of bronchopulmonary dysplasia (BPD) in preterm infants. However, conflicting results have been reported. OBJECTIVE:We conducted this met...
journal_title:Pediatrics
pub_type: 杂志文章,meta分析
doi:10.1542/peds.2019-0181
更新日期:2019-07-01 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of an emergency department (ED)-based home safety intervention on caregivers' behaviors and practices related to home safety. METHODS:We conducted a randomized, clinical trial of 96 consecutive caregivers of children who were younger than 5 years and presented to an urban pediatri...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.113.6.1603
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Thyroid hormones are essential for brain development. We conducted a randomized, controlled trial with thyroxine (T4) supplementation in infants <30 weeks' gestation and with the last neurodevelopmental follow-up moment at the age of 5.5 years. T4 supplementation was associated with improved outcome of infan...
journal_title:Pediatrics
pub_type: 杂志文章,随机对照试验
doi:10.1542/peds.2005-0876
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVE:The Neonatal Individualized Developmental Care Program (NIDCAP) for very low birth weight (VLBW) preterm infants has been suggested by Als et al to improve several medical outcome variables such as time on ventilator, time to nipple feed, the duration of hospital stay, better behavioral performance on Assessm...
journal_title:Pediatrics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1542/peds.100.6.e9
更新日期:1997-12-01 00:00:00
abstract:BACKGROUND:As extremely preterm infant mortality rates have decreased, concerns regarding resource use have intensified. Accurate models for predicting time to hospital discharge could aid in resource planning, family counseling, and stimulate quality-improvement initiatives. OBJECTIVES:To develop, validate, and compa...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2009-0810
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Although suicide is a known leading cause of death among street youth, few prospective studies have explored childhood experiences as risk factors for future suicide attempt in this population. We examined the risk of attempted suicide in relation to childhood maltreatment among street youth. METHODS:From S...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.2015-1108
更新日期:2015-09-01 00:00:00
abstract::The purpose of this statement is to update recommendations for routine use of seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. The American Academy of Pediatrics recommends annual seasonal influenza immunization for all people 6 months and older, including...
journal_title:Pediatrics
pub_type: 杂志文章,实务指引
doi:10.1542/peds.2015-2920
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVE:To assess the frequency of clinician-reported delivery of counseling for avoidance of child environmental tobacco smoke (ETS) exposure and tobacco use at periodic well-child visits and at illness visits for asthma and otitis media (OM). METHODS:Combined data from the National Ambulatory Medical Care Survey a...
journal_title:Pediatrics
pub_type: 杂志文章
doi:10.1542/peds.111.2.e162
更新日期:2003-02-01 00:00:00