PT - JOURNAL ARTICLE AU - Peter Aaby AU - Henrik Ravn AU - Adam Roth AU - Amabelia Rodrigues AU - Ida Maria Lisse AU - Birgitte Rode Diness AU - Karen Rokkedal Lausch AU - Najaaraq Lund AU - Julie Rasmussen AU - Sofie Biering-Sørensen AU - Hilton Whittle AU - Christine Stabell Benn TI - Early diphtheria-tetanus-pertussis vaccination associated with higher female mortality and no difference in male mortality in a cohort of low birthweight children: an observational study within a randomised trial AID - 10.1136/archdischild-2011-300646 DP - 2012 Aug 01 TA - Archives of Disease in Childhood PG - 685--691 VI - 97 IP - 8 4099 - http://adc.bmj.com/content/97/8/685.short 4100 - http://adc.bmj.com/content/97/8/685.full SO - Arch Dis Child2012 Aug 01; 97 AB - Background Studies from low-income countries have suggested that diphtheria-tetanus-pertussis (DTP) vaccine provided after Bacille Calmette-Guerin (BCG) vaccination may have a negative effect on female survival. The authors examined the effect of DTP in a cohort of low birthweight (LBW) infants. Methods 2320 LBW newborns were visited at 2, 6 and 12 months of age to assess nutritional and vaccination status. The authors examined survival until the 6-month visit for children who were DTP vaccinated and DTP unvaccinated at the 2-month visit. Results Two-thirds of the children had received DTP at 2 months and 50 deaths occurred between the 2-month and 6-month visits. DTP vaccinated children had a better anthropometric status for all indices than DTP unvaccinated children. Small mid-upper arm circumference (MUAC) was the strongest predictor of mortality. The death rate ratio (DRR) for DTP vaccinated versus DTP unvaccinated children differed significantly for girls (DRR 2.45; 95% CI 0.93 to 6.45) and boys (DRR 0.53; 95% CI 0.23 to 1.20) (p=0.018, homogeneity test). Adjusting for MUAC, the overall effect for DTP vaccinated children was 2.62 (95% CI 1.34 to 5.09); DRR was 5.68 (95% CI 1.83 to 17.7) for girls and 1.29 (95% CI 0.56 to 2.97) for boys (p=0.023, homogeneity test). While anthropometric indices were a strong predictor of mortality among boys, there was little or no association for girls. Conclusion Surprisingly, even though the children with the best nutritional status were vaccinated early, early DTP vaccination was associated with increased mortality for girls.