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Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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Index

A

Adenylate cyclase, 334

Adults

anaphylactic reactions, 147

arthritis reactions, 21, 24, 187, 189, 194-195, 196, 197

pertussis incidence, 9

rubella incidence, 19, 21

rubella vaccination, 23, 24, 39

Adverse events, 1, 32-33, 46

causality, 3, 4-8, 33-36, 47-48, 59-62

data sources, 38-39, 48-52, 206, 293-294, 337

pertussis vaccination, v, vi, vii, 2, 4-8, 18-19, 32, 38, 46, 50n.3, 52, 323, 348

rubella vaccination, v, vi, vii, 2, 8, 23-24, 32, 38, 46, 52, 71, 328

Advisory Commission on Childhood

Vaccines (ACCV), vi, 325, 326, 329

Afebrile seizures, 2, 88, 90

DPT vaccination and, 72, 94, 106, 108, 111, 112, 113, 118, 118n.3, 338-339

meta-analysis of data, 52, 115

Agonal anoxia, 125

Airway obstruction, 145

Albumin, 116, 148

Allergic reactions, 40, 48, 144, 177

Aluminum salts, 70, 116, 153, 347-348

American Academy of Pediatrics (AAP), 17, 321, 324

American Medical Association (AMA), 17, 320

American Psychiatric Association (APA), 162

Anaphylaxis, 40, 47-48, 177, 283

animal studies, 148-149, 150

case reports, 146

controlled studies, 146-148

human studies, 146-148

pertussis vaccine and, 8, 71, 146, 149-150, 172, 175

Angioneurotic edema, 150, 172

Animal experiments, 4, 39-41, 59, 83, 118, 347

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Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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anaphylaxis, 148-149, 150

encephalopathy, 115-116, 117

juvenile diabetes, 160-161

pertussis, 14, 40, 115-116, 333-335

rubella, 40, 41, 194

thrombocytopenia, 178

Anoxemia, 89

Antibodies, 40

blood platelet, 199

DPT vaccine, 157, 158, 159

immunoglobulin, 144, 145, 146, 147, 150, 192

rubella, 192

Antigens, 40, 200

anaphylaxis, 144, 145

blood platelet, 199

in DPT vaccine, 54, 146, 148, 150, 157, 159

rubella, 195

tetanus, 156, 157

Apnea, 126, 140

Arachidonic acid metabolism, 144

Arthralgia, 187, 283

rubella vaccination and, 8, 21, 24, 55, 188, 191, 192, 195, 196, 328

Arthritis, vii, 187, 206, 283

case reports, 189, 191-193, 196

controlled studies, 39, 189-190, 194, 196

diagnosis, 195

epidemiology, 188

human studies, 189-194, 329

rubella vaccination and, 8, 21, 24, 55, 187, 188, 194-197, 328, 329

Arthropathy, 187, 283

rubella vaccination and, 189, 190, 191, 192, 195, 196

Arthus reaction, 145-146, 148, 150

Aseptic meningitis, 82, 283

case reports, 84

controlled studies, 84-85

diagnosis, 84

epidemiology, 83

human studies, 84-85

pertussis vaccination and, 4, 70, 83, 85-86

Aspirin, 169, 170, 171

Association of Parents of Vaccine Damaged Children, 19, 322

Attention deficit disorder (ADD), 4, 161, 162, 163, 164, 283-284

Attributable fraction, 284

Attributable risk, 35, 42, 284

encephalopathy, 104, 114-115, 117, 323

See also Relative risk

Autism, 4, 284

diagnosis, 152

epidemiology, 151

human studies, 151-152

Autopsy, 129, 145, 146, 149

B

Bacteremia, 145

Bacterial endotoxin, 40, 149

Bacterial meningitis, 70, 82

Bias, 3, 35, 50, 56, 138, 206, 284

''information bias," 45

in NCES data, 44-45

"recall bias," 72, 103

Biologic plausibility, 3, 4, 54, 59

anaphylaxis, 47-48, 150

arthritis, 195, 196

erythema multiforme, 47-48, 154

hemolytic anemia, 48

radiculoneuritis, 199

sudden infant death syndrome, 140

thrombocytopenic purpura, 201

Birth trauma, 66

Birth weight, 126, 127, 136

Blacks

arthritis incidence, 188

diabetes incidence, 159-160

sudden infant death syndrome and, 126, 127

Bordet, Jules, 320

Bordetella avium, 14

Bordetella bronchiseptica, 14, 334

Bordetella parapertussis, 14

Bordetella pertussis, 9, 10, 11, 12, 14-17, 320

animal studies, 14, 40, 115-116, 333-335

Continued on next page

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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in vaccines, 17, 91

Bordet-Gengou technique, 11, 17, 320

Brachial neuritis, 156, 157

Brain damage, 162

neurologic illness and, 87

pertussis vaccination and, 91, 101, 149, 321, 323, 325-326

Bronchospasm, 145

Burnet, Macfarlane, 23, 327

C

Campylobacter jejuni, 154

Cardiovascular collapse, 145

Carpal tunnel syndrome, 197, 198

Case-comparison (case-control) studies, 43-45, 59, 284-285

Case Report Review Form, 47, 302-311

Case reports and case series, 3, 4, 8, 46-48, 59, 300

anaphylaxis, 146

arthritis, 189, 191-193, 196

aseptic meningitis, 84

encephalopathy, 47, 91-95, 117

erythema multiforme, 152-153

Guillain-Barré syndrome, 155

hemolytic anemia, 158-159

hypsarrhythmia, 80

infantile spasms, 67-69, 76

juvenile diabetes, 160

learning disabilities, 163

peripheral mononeuropathy, 156-157

protracted crying and screaming, 165-166

radiculoneuritis, 55, 198-199

Reye syndrome, 170-171

shock, 172-173, 177

sudden infant death syndrome, 128-130, 138

thrombocytopenia, 178

thrombocytopenic purpura, 55, 200

"Catcher's crouch syndrome," 23-24, 191, 197, 198

Causality, 4-8

adverse events, inference of, 3, 33-36, 37-38, 48, 51, 52-55, 56, 59-62

anaphylaxis, 150

arthritis, 197

aseptic meningitis, 85, 86

autism, 152

encephalopathy, 118

erythema multiforme, 154

Guillain-Barré syndrome, 156

hemolytic anemia, 159

hypsarrhythmia, 82

infantile spasms, 77

juvenile diabetes, 161

learning disabilities, 164

neurologic damage, 168-169

peripheral mononeuropathy, 157

radiculoneuritis, 199

Reye syndrome, 171

seizures, 118n.3

shock, 177

sudden infant death syndrome, 130, 141

thrombocytopenia, 179

thrombocytopenic purpura, 201

Cellular hypersensitivity, 67

Centers for Disease Control (CDC), 12, 24, 48, 49, 169, 170, 322, 329

Central nervous system (CNS)

complications of pertussis, 11-12

infections, 66, 70, 82, 84-85, 107

inflammation, 89

Cerebral anomalies, 66

Cerebral disorder. See Encephalopathy

Cerebral edema, 169

Cerebral glucose utilization, 163

Cerebral injury, 98

Cerebral spinal fluid (CSF), 82, 86, 88, 98, 100, 154-155

Child Health and Education Study (CHES), 323-324

Children

arthritis incidence, 188, 190, 191, 195

aseptic meningitis, 83

autism, 151

encephalopathy and seizures, 88, 106, 116

Guillain-Barré syndrome, 155

hypsarrhythmia, 67

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Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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juvenile diabetes, 159

neurologic illness, 44, 87

neuropathies, 198

pertussis incidence, 9, 13, 14, 19

pertussis vaccination, 17, 33, 39, 89-90, 127, 321, 322, 324

rubella incidence, 19, 21, 327

rubella vaccination, 22-23, 24, 326-327

sudden infant death syndrome, 125, 127

See also Human studies

Children's Hospital (Boston), 92

Children's Hospital Medical Center (Cincinnati), 170

Children's Memorial Hospital (Chicago), 81

Chomel, A. F., 154

Chromosomal disorders, 66

Circulating immune complexes (CIC), 194-195

Clinical trials, 34

acellular pertussis vaccines, 18

rubella vaccine, 24

Cohort studies, 42-43, 130, 285

Coma, 88, 100, 169

"Compensation for Vaccine-Related Injuries" (OTA), 200

Computed tomography, 66

Confidence intervals, 58, 136, 139, 341-342

Confounding factors, 3, 33, 35, 50, 101, 103-104, 206

Controlled epidemiologic studies, 3, 4, 38-39, 41-46, 59, 285, 300

anaphylaxis, 146-148

arthritis, 39, 189-190, 194, 196

aseptic meningitis, 84-85

encephalopathy, 41, 42, 43, 52, 107-115, 117, 118

hypsarrhythmia, 80-82

infantile spasms, 69-76, 78-79

juvenile diabetes, 160

learning disabilities, 163-164

protracted crying and screaming, 166-168

Reye syndrome, 170

shock, 173-177

sudden infant death syndrome, 130-140

Controlled Study Review Form, 312-319

Convulsions, 71, 87, 88, 98, 101, 106.

See also Afebrile seizures; Febrile seizures; Seizures

Convulsive disorder, 107

Cortical atrophy, 66

Cost-benefit analysis, 1-2, 38

Coulter, Harris L., vii, 324

Cross-sectional surveys, 45

Cyanosis, 172, 176

Cytomegalovirus, 154

D

Data sources, 293-294

de Baillou, Guillaume, 9-10

Denmark, 66, 69-70, 76-77

Developmental abnormalities, 104, 105

Diagnosis

arthritis, 195

aseptic meningitis, 84

autism, 152

encephalopathy, 113, 117

Guillain-Barrè syndrome, 154-155, 156

infantile spasms, 66, 74

learning disabilities, 164

pertussis, 11

rubella, 20

Diagnostic and Statistical Manual of Mental Disorders (APA), 162

Dialysis, 347

Diphtheria antibodies, 158

Diphtheria-pertussis-tetanus (DPT) vaccine, 2, 4, 8, 39, 42, 338-339

aluminum salts in, 116, 153, 347, 348

development of, 17, 321

endotoxin in, 149, 150

immunization schedules, 54-55

and sudden infant death syndrome, 33, 51, 127, 128-129

and ventilatory patterns, 140

See also Pertussis vaccine

Diphtheria vaccine, 54, 150

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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Disease surveillance systems, 49

Dissatisfied Parents Together, 19, 93, 300, 323, 324

Dose-response relation, 52, 53

DPT: A Shot in the Dark (Coulter and Fisher), vii, 324

Drop seizures, 69

Dyslexia, 161

E

Early and Periodic Screening, Diagnosis, and Treatment, 327

Electroencephalogram (EEG) pattern, 100, 162

hypsarrhythmia, 65, 73, 77, 80-82

infantile spasms, 77, 82

Encephalitis, 2, 21, 84, 86, 90, 100, 101, 112, 118. See also Encephalopathy

Encephalomyelitis, 2, 86, 100, 118. See also Encephalopathy

Encephalopathy, 2, 12n.3, 86-88, 149, 285, 347

animal studies, 115-116, 117

case reports, 47, 91-95, 117

controlled studies, 41, 42, 43, 52, 107-115, 117, 118

diagnosis, 113, 117

epidemiology, 90

following pertussis, 11-12, 88-89

human studies, 91-115, 117

National Childhood Encephalopathy Study (NCES), 52, 99-107

pathology, 89-90, 206

pertussis vaccination and, vii, 8, 47, 87, 88, 89-90, 91, 117-118, 344-345, 348

in Reye syndrome, 169

Endotoxemia, 145

Endotoxin, 40, 145, 153, 335

in DPT vaccine, 148, 149, 150, 166

Enteroviruses, 83

Enzyme-linked immunosorbent assay (ELISA), 192

Epidemiologic studies, 8, 33, 34, 35, 206, 337

resolution, 56-58

See also Controlled epidemiologic studies

Epidemiology

arthritis, 188

aseptic meningitis, 83

autism, 151

encephalopathy, 90

erythema multiforme, 152

Guillain-Barrè syndrome, 155

hemolytic anemia, 158

hypsarrhythmia, 77

infantile spasms, 65-66

juvenile diabetes, 159-160

learning disabilities, 162-163

peripheral mononeuropathy, 156

pertussis, 9-14, 40

radiculoneuritis, 197-199

Reye syndrome, 170

rubella, 19-22

sudden infant death syndrome, 125, 126-127

thrombocytopenia, 178

thrombocytopenic purpura, 199

Epilepsy, 65, 88, 90, 95

pertussis vaccination and, 2, 70, 93-94, 98, 106, 107, 108, 118, 118n.3, 173

Epstein-Barr virus, 154

Error types, 57

Erythema multiforme, 46, 285

case reports, 152-153

epidemiology, 152

human studies, 152-153

pertussis vaccination and, 4, 47-48, 153-154

Experimental studies, 3, 8, 39, 206-207, 285

F

Family income, 126

Faroe Islands, 18, 320-321

Febrile convulsions, 72

Febrile seizures, 2, 87-88, 90

meta-analysis of data, 52, 115

pertussis vaccination and, 70, 94, 98-

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Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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99, 106, 107-110, 112, 113, 117-118, 118n.3

Females

arthritis incidence, 21, 24, 188, 189-190, 191, 192-193, 194-195, 196, 197

autism rates, 151

pertussis incidence in, 13, 88

rubella epidemic and, 327

rubella vaccination, 23, 329

Fever, 172

Finland, 66

Fisher, Barbara Loe, vii, 324

Food and Drug Administration (FDA), 322-323

Fountain Hospital (London), 92

France, 23

G

Gengou, Octave, 320

German measles. See Rubella

Gregg, Norman McAlister, 327

Group Health Cooperative hospitals, 72, 108, 137

Guillain-Barrè syndrome (polyneuropathy), 46, 285

case reports, 155

diagnosis, 154-155, 156

epidemiology, 155

human studies, 155

MMR vaccination and, 198

pertussis vaccination and, 4, 155-156

H

Haemophilus influenzae meningitis, 72

Haemophilus influenzae vaccine, 153

Hamsters, 335

Handicapped children, 75

Hatch, Orrin G., 324

Hawkins, Paula, 323, 324

Hemagglutination inhibition (HAI), 192

Hemagglutinin, 334

Hemiparesis, 98

Hemolytic anemia, 38, 46, 157, 178, 285-286

case reports, 158-159

epidemiology, 158

human studies, 158-159

pertussis vaccination and, 4, 48, 159

Hepatitis vaccine, 155

Hess, A. F., 326

Hill, A. B., 52

Hiro, Y., 22-23, 326-327

Histamine, 16, 144, 147-148, 153

Hives, 150

Human immunodeficiency virus, 154

Human studies, 4, 38-39, 59, 206-207, 300

anaphylaxis, 146-148

arthritis, 189-194, 329

aseptic meningitis, 84-85

autism, 151-152

encephalopathy, 91-115, 117

erythema multiforme, 152-153

Guillain-Barrè syndrome, 155

hemolytic anemia, 158-159

hypsarrhythmia, 80-82

infantile spasms, 67-76

juvenile diabetes, 160

learning disabilities, 163-164

peripheral mononeuropathy, 156-157

protracted crying and screaming, 165-168

radiculoneuritis, 198

Reye syndrome, 170-171

shock, 172-176

sudden infant death syndrome, 128-140

thrombocytopenia, 178

thrombocytopenic purpura, 200

Hyperactivity, 161, 162, 163, 173, 286

Hyperimmunization, 148

Hyperinsulinemia, 16

Hyperkinesis, 162

Hypoglycemia, 16, 93, 160

Hypotonia, 91

Hypotonic diplegia, 67

Hypotonic, hyporesponsive episodes (HHE), 52, 93, 147, 160, 161, 171-177.

See also Shock

Hypotonicity, 286

Hypovolemia, 116

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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Hypsarrhythmia (mountainous arrhythmia), 65, 69, 73, 286

case reports, 80

controlled studies, 80-82

epidemiology, 77

human studies, 80-82

pertussis vaccination and, 8, 67, 77, 82, 98

I

Immune system, 40, 41, 67, 145, 157, 178, 195

Immunization, 286.

See also Vaccination

Immunization Practices Advisory Committee, 127, 128

Immunoglobulin (Ig) antibodies, 144, 145, 146, 147, 150, 192

India, rubella epidemic in, 20

Infantile spasms, 286

case reports, 67-69, 76

controlled studies, 69-76, 78-79

diagnosis, 66, 74

epidemiology, 65-66

human studies, 67-76

pertussis vaccination and, 8, 57, 67, 76-77, 100, 101, 103, 112

Influenza vaccination, 154

"Information bias," 45

Institute of Medicine (IOM), v, vii, 1-2, 325, 326, 328, 329

Insulin-dependent diabetes mellitus (IDDM), 159

Interleukin-1, 145

International Classification of Disease (ICD) codes

anaphylaxis, 147

arthritis, 193

aseptic meningitis, 84

autism, 151

encephalopathy, 94

epilepsy, 95

erythema multiforme, 153

Guillain-Barrè syndrome, 155

hemolytic anemia, 158-159

hypotonic, hyporesponsive episodes, 173

infantile spasms, 69

juvenile diabetes, 160

learning disabilities, 163

. peripheral mononeuropathy, 157

radiculitis, 198

Reye syndrome, 171

screaming, 166

seizures, 94

sudden infant death syndrome, 129

thrombocytopenia, 178

thrombocytopenic purpura, 200

International Symposium on Pertussis, 105, 326

Intracerebral mouse protection test, 334-335

Intracranial hemorrhage, 66

Intranasal mouse protection test, 116, 335

IQ scores, 97, 162, 175

Islet-activating protein (pertussis toxin), 160

Italy, 23

J

Japan, 17-18, 322

Japanese encephalitis vaccine, 68

Jarisch-Herxheimer reaction, 145, 150

"Joint manifestations," 187

Juvenile diabetes, 4, 286

animal studies, 160-161

case reports, 160

controlled studies, 160

epidemiology, 159-160

human studies, 160

pertussis vaccination and, 4, 161

K

Kanner, L., 151

Kendrick, Pearl, 17, 321

L

Laryngeal edema, 145, 146

"Late dysfunction," 105

Lawsuits, 324, 325

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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Learning disabilities, 4, 161-162, 173, 286

case reports, 163

controlled studies, 163-164

diagnosis, 164

epidemiology, 162-163

human studies, 163-164

pertussis vaccination and, 4, 164

Leukocytes, 82, 196

Leukocytosis, 167, 176

Longitudinal studies, 106

Lyme disease, 154

Lymphocytes, 40, 88, 195

Lymphocytosis, 16

Lymphocytosis-promoting factor (LPF), 18, 94

M

Madsen, Thorvald, 17, 18, 46, 320-321

Males

arthritis incidence, 192-193

autism rates, 151

meningitis rates, 83

sudden infant death syndrome, 126

Masked studies, 286-287

Maternal characteristics, SIDS risk, 126, 127, 136

Measles, 323

Measles immunization, 103

Measles-mumps-rubella (MMR) vaccine, 55, 93, 153, 155, 163, 171, 178, 200, 289

and arthritis, 193, 196

and radiculoneuritis, 198-199

See also Rubella vaccine

Medicaid, 42, 110-111, 137, 327

Megakaryocytes, 200

Meningitis, 84.

See also Aseptic meningitis

Menstrual cycle, 194

Mental retardation, 87, 165-166, 168, 177, 206

Merck Sharp & Dohme Company, 23, 200

Meruvax II, 200

Meta-analysis, 3, 51-52, 56, 58, 115, 138-140, 141, 176, 340-345

Metabolic disorders, 66

Methodology, 2-3, 32-33

meta-analysis, 340-345

power calculations, 37, 56-58, 337-340

Mice, 16, 115-116, 148, 153, 333-335

Microcephaly, 66

Monitoring System for Adverse Events Following Immunization (MSAEFI), 48-49, 287, 300

anaphylaxis, 147, 150

arthritis, 193

aseptic meningitis, 84

autism, 151

encephalopathy and seizures, 93, 94

erythema multiforme, 153-154

Guillain-Barrè syndrome, 155-156

hemolytic anemia, 158-159

hyperactivity and learning disability, 163, 164

infantile spasms, 69

juvenile diabetes, 160

peripheral mononeuropathy, 157

protracted crying and screaming, 166

radiculitis, 198

Reye syndrome, 171

shock, 173

sudden infant death syndrome, 129

thrombocytopenia, 178-179

thrombocytopenic purpura, 200-201

Monitoring System for Illness Following Immunization (MSIFI), 322

Mortality, 1

anaphylaxis, 145

encephalopathy, 88

pertussis, 13, 14

pertussis vaccination, 18-19, 71, 89-90, 91, 93, 116, 148, 320-321, 322

pneumonia, 92

rubella, 21

shock, 172

sudden infant death syndrome, 125, 126-127, 128, 140, 141

Motor retardation, 87, 165-166, 168, 177

Mouse weight gain test, 116, 166-167, 335

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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Mumps virus, 83

Mycoplasma, 154

Myoclonic seizures, 67

N

National Childhood Development Study, 164

National Childhood Encephalopathy Study (NCES), 322, 323

encephalopathy and seizures, 12, 52, 86, 99-107, 117-118, 344

infantile spasms, 73-74, 76-77, 100, 101, 103

methodology, 44-45, 100-101, 112-113

Reye syndrome, 170, 171

National Childhood Vaccine Injury Act (1986), v-vi, 1, 324, 325, 328

National Collaborative Perinatal Project (NCPP), 88, 99, 106, 107

National Health Examination Survey (NHES), 188

National Health Interview Surveys (NHIS), 188

National Health and Nutrition Examination Survey (NHANES), 188

National Institute of Allergy and Infectious Diseases (NIAID), v, 326

National Institute for Biological Standards and Control (NIBSC), 55

National Institute of Child Health and Human Development (NICHD), 126

National Institutes of Health (NIH), 148

National Reye Syndrome Surveillance System, 170

National Vaccine Advisory Committee (NVAC), 325, 329

National Vaccine Information Center (NVIC), 326

National Vaccine Injury Compensation Program (VICP), 325, 326, 329

National Vaccine Program (NVP), 325, 328

Netherlands, 55

Neurocutaneous syndromes, 66

Neuroimaging techniques, 66

Neurologic damage, 4, 19, 105, 107, 117, 118, 168-169, 177

Neurologic disability, 88-89, 91

Neurologic disorders, 19, 71, 100

Neurologic illness, 44, 72, 87, 101, 102-103, 104, 113, 323.

See also Encephalopathy

Neuropathies, 8, 23, 46, 328.

See also Peripheral mononeuropathy

Neurotoxic effect, 67

Neurotransmitter systems, 163

Neurotropic virus infection, 67

Neva, F. A., 22

New and Nonofficial Remedies (AMA), 17, 320

Nicolle, Charles, 17, 320

Noncontrolled clinical studies, 46, 287

North West Thames Study, 71, 76, 97, 146-147, 167, 175, 324

Null hypothesis, 35, 57

Nutritional deficiencies, 12

O

Odds ratio, 34, 43-44, 51-52, 53, 287, 337-338

infantile spasms, 76-77

neurologic illness, 113

sudden infant death syndrome, 136, 138, 341, 342-344

Optic neuritis, 198

Otitis media, 193n.1

P

Paralysis, 100

Paralytic syndromes, 112

Parapertussis, 14, 287

Paresis, 156-157

Paresthesias, 197, 198

Parke-Davis & Company, 321

Parkman, Paul D., 22, 23, 327

Pathologic mechanisms, 206

Perinatal hypoxia, 66

Peripheral mononeuropathy, 4, 46, 287

Continued on next page

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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case reports, 156-157

epidemiology, 156

human studies, 156-157

pertussis vaccination and, 4, 157

Peripheral neuropathy, vii, 197, 198, 199

Pertussis (whooping cough), 9n.1, 287

complications, 11-12

encephalopathy following, 11-12, 88-89

epidemiology, 9-14, 40

Pertussis antibody, 158

"Pertussis reaction syndrome," 87

Pertussis toxin (PT), 16, 94, 147, 149, 160, 334, 335

Pertussis vaccine, 1, 13, 39, 44, 45-46, 57, 207, 289

acellular vaccines, 17-18, 39

adsorbed vaccines, 54, 55, 98, 167, 289, 347-348

animal models, 40, 41, 333-335

development of, 17-18, 320-326, 334-335

exposure, 3

toxicity, 166-167

whole-cell vaccines, 17, 18, 39, 54, 55

Pertussis vaccine, adverse events, v, vi, vii, 2, 4-8, 18-19, 32, 38, 46, 50n.3, 52, 323, 348

anaphylaxis, 8, 71, 146-150, 172, 175

aseptic meningitis, 4, 70, 83-86

autism, 4, 152

encephalopathy, 8, 47, 87, 88, 89-90, 91-118, 344-345, 348

erythema multiforme, 4, 47-48, 153-154

Guillain-Barrè syndrome, 4, 155-156

hemolytic anemia, 4, 48, 158-159

hypsarrhythmia, 8, 67, 77-82, 98

infantile spasms, 8, 57, 67-77, 100, 101, 103, 112

juvenile diabetes, 4, 160-161

learning disabilities, 4, 163-164

peripheral mononeuropathy, 4, 157

protracted crying and screaming, 4, 8, 87, 165-169

Reye syndrome, 8, 170-171

shock, 8, 87, 98, 172-177

sudden infant death syndrome, 8, 33, 46, 51, 52, 128-141, 322, 339, 340, 342

thrombocytopenia, 8, 178-179

"Pertussis vaccine-induced encephalopathy," 87, 117

Pervasive developmental disorders, 151

Petechiae, 125, 178, 199, 200

Physicians, 49

Platelet-activating factor, 144

Platelet counts, 177-178, 199, 200

Pneumonitis, 125

Polio, 321

Polio vaccine, oral (OPV), 68, 71, 84, 93, 153, 155, 158, 163, 170, 171, 178, 321

Polyneuritis, 21, 154

Polyneuropathy, 154, 155, 197

Polyradiculitis, 154

Positron tomography, 66

Power calculations, 37, 56-58, 337-340

Pregnancy

antibody transmission in, 145

complications, 151

intrauterine infections, 66

rubella transmission in, 19, 20, 22, 327

Primates, 333

Progressive neurologic deterioration, 67

Proteins, 149, 150

cerebral spinal fluid, 155

pertussis toxin, 16

Protracted crying and screaming

case reports, 165-166

controlled studies, 166-168

human studies, 165-168

pertussis vaccination and, 4, 8, 87, 165, 168-169

Psychomotor retardation, 65, 67

Public Health Service (PHS), 49-50

Q

Quadrigen vaccine, 321

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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R

Rabbits, 333

Radiculoneuritis, vii, 46, 191, 287

case reports, 55, 198-199

epidemiology, 197-198

human studies, 198

rubella vaccination and, 8, 55, 197, 198-199

Rashes, 4, 46, 152

aluminum salts and, 153, 347

rubella, 20

Rats, 148, 333

Reading disability, 161

"Recall bias," 103

Regan-Lowe technique, 11

Relative risk, 42, 287-288

arthritis, 196

aseptic meningitis, 84

encephalopathy and seizures, 97, 98, 101, 103-104, 105, 106, 108, 110, 111-112, 113, 115, 117, 118, 345

infantile spasms, 72, 73-74, 75, 76

and inference of causality, 4, 34, 51-52, 53, 58, 59-62

shock and HHE, 175, 176

sudden infant death syndrome, 51, 131, 138, 140

Renal failure, 148, 347

Report of the Task Force on Pertussis and Pertussis Immunization (AAP), vii

Research needs, 8, 206-207

Respiratory complications, pertussis, 11

Reye syndrome, 169-170, 288

case reports, 170-171

controlled studies, 170

epidemiology, 170

human studies, 170-171

in NCES data, 100, 103, 105, 107, 112, 170

pertussis vaccination and, 8, 171

Rheumatism, 187, 188

Risk-benefit analysis, 1-2, 38

Risk estimates. See Relative risk

Rubella (German measles), 288, 327

arthritis following, 187, 191, 193

complications, 20

diagnosis, 20

epidemiology, 19-22

radiculoneuritis following, 197, 199

thrombocytopenic purpura, 199

Rubella panencephalitis, 21

Rubella vaccine, 1, 22, 39, 55, 289

animal models, 40, 41

development of, 22-23, 326-329

exposure, 3

Rubella vaccine, adverse events, v, vi, vii, 2, 8, 23-24, 32, 38, 46, 52, 71, 328

arthritis, 8, 21, 24, 55, 187, 188-197, 328, 329

radiculoneuritis, 8, 55, 198-199

thrombocytopenic purpura, 8, 55, 200-201

Rubella virus, 21, 22, 23

S

Salk polio vaccine, 321

Sauer, Louis, 19, 321

Seizure disorders, 90, 108

Seizures, 42, 43, 87-88, 177

aseptic meningitis and, 82

infantile spasms and, 65, 66, 67, 75-76

in NCES data, 100, 101, 103, 105, 106, 112

pertussis vaccination and, 87, 93-94, 95-97, 118

See also Afebrile seizures; Febrile seizures

Shock, 16, 116, 145, 146, 171-172

case reports, 172-173, 177

controlled studies, 173-177

human studies, 172-176

pertussis vaccination and, 8, 87, 98, 172, 176-177

Sleep apnea, 126

Smallpox vaccine, 68

Social Security Act (1965), 327

Socioeconomic status, 44, 104, 137, 140, 164

Spastic diplegia, 67

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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States

vaccination requirements, v, 17, 321, 328

Statistical analysis, 37

Study of Neurological Illness in Children (SONIC), 74-75, 76, 112-113, 114, 300, 325, 338

Sudden infant death syndrome (SIDS), vii, 93, 288

case reports, 128-130, 138

controlled studies, 130-140

diagnosis, 125-126

epidemiology, 125, 126-127

human studies, 128-140

pertussis vaccination and, 8, 33, 46, 51, 52, 128, 140-141, 322, 339, 340, 342

SIDS Cooperative Epidemiologic Study, 126, 127, 136

Supplementary Pertussis Surveillance System (SPSS), 12, 13

Sweden, 80, 323

Switzerland, 23

Synovial membrane infection, 194, 196

T

Tachycardia, 172

Tasaka, S., 22-23, 326-327

Task Force Report on Pertussis, 324

Tennessee Department of Health, 128

Tetanus vaccine, 54, 150, 154, 156, 157, 158

Thrombocytopenia, 21, 46, 177-178, 288

case reports, 178

epidemiology, 178

human studies, 178

pertussis vaccination and, 8, 178-179

Thrombocytopenic purpura, 46, 178, 288

case reports, 55, 200

epidemiology, 199

human studies, 200

rubella vaccination and, 8, 55, 200-201

Tokyo Women's Medical College, 68

Toxemia, 115, 333

''Toxic effects," 89

Toxicity, 166-167, 335

Tuberous sclerosis, 66, 75-76

Tuberous Sclerosis Association of Great Britain, 75

Tumor necrosis factor, 145

Twins, 129, 146

U

United Kingdom

pertussis mortality in, 14

pertussis vaccination in, 19, 39, 44, 55, 321-322, 325

Reye syndrome incidence, 170

rubella incidence, 22

rubella vaccination in, 23

Vaccine Damage Payment Act, 323

See also National Childhood Encephalopathy Study (NCES)

United States, 322

arthritis incidence, 188

DPT vaccination in, 17, 19, 39, 54, 69, 128, 321, 348

Guillain-Barrè syndrome incidence, 155

infantile spasms incidence, 66

juvenile diabetes incidence, 159

pertussis incidence, 13, 14

Reye syndrome incidence, 170, 171

rubella incidence, 22, 23, 327

rubella vaccination in, 23, 24, 55, 199, 328

sudden infant death syndrome deaths, 128-129, 140

U.S. Congress, v, 325, 328

U.S. Department of Health and Human Services (DHHS), 324

University of California, Los Angeles, 323

University of Illinois Medical Center, 81

"Unusual shock-like state," 8

Urticaria, 146, 172

V

Vaccination, v, 1, 9n.2, 47, 288-289

immunization schedules, 54-55

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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research needs, 8, 206-207

vaccine composition, 54, 55, 117

vaccine exposure, 3, 32-33, 34

See also Adverse events

Vaccine Adverse Event Reporting System (VAERS), 49-50

Vaccine Compensation Amendments (1987), v

Vaccine Damage Payment Act (U.K.), 323

Vaccine Supply and Innovation (IOM), vii

Vasculitis, 148

Viral encephalitis, 82, 103, 105, 107

W

Waxman, Henry, 324

Wechsler Intelligence Scale for Children, 97, 175

Weller, Thomas H., 22, 23, 327

West syndrome, 65

Whites

arthritis incidence, 188

juvenile diabetes in, 159-160

pertussis incidence, 13

Whooping cough. See Pertussis

Wilkins, Jeanette, 295

World Health Organization (WHO), 13

WRC-TV, 19, 93, 323

Wyeth Laboratories, Inc., 322, 324

Suggested Citation:"Index." Institute of Medicine. 1991. Adverse Effects of Pertussis and Rubella Vaccines. Washington, DC: The National Academies Press. doi: 10.17226/1815.
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Adverse Effects of Pertussis and Rubella Vaccines Get This Book
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Parents have come to depend on vaccines to protect their children from a variety of diseases. Some evidence suggests, however, that vaccination against pertussis (whooping cough) and rubella (German measles) is, in a small number of cases, associated with increased risk of serious illness.

This book examines the controversy over the evidence and offers a comprehensively documented assessment of the risk of illness following immunization with vaccines against pertussis and rubella. Based on extensive review of the evidence from epidemiologic studies, case histories, studies in animals, and other sources of information, the book examines:

  • The relation of pertussis vaccines to a number of serious adverse events, including encephalopathy and other central nervous system disorders, sudden infant death syndrome, autism, Guillain-Barre syndrome, learning disabilities, and Reye syndrome.
  • The relation of rubella vaccines to arthritis, various neuropathies, and thrombocytopenic purpura.

The volume, which includes a description of the committee's methods for evaluating evidence and directions for future research, will be important reading for public health officials, pediatricians, researchers, and concerned parents.

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