Pertussis Vaccine

PEDIATRICS ◽  
1984 ◽  
Vol 74 (2) ◽  
pp. 303-305
Author(s):  
Keyword(s):  
Informed Consent ◽  
Pertussis Vaccine ◽  
Adverse Reactions ◽  
Medical Profession ◽  
Scientific Information ◽  
Vaccine Dose ◽  
Childhood Diseases ◽  
Immunization Rates ◽  
The United Kingdom ◽  
New Information

The "Red Book," as the Report of the Committee on Infectious Diseases has come to be known, is not a static document, but is subject to frequent revision. Not only does each edition contain new information available to the Committee, but between editions the Committee communicates further changes to the medical profession via Pediatrics. These communications constitute "Updates" to the Red Book. As everyone knows, scientific information proliferates exponentially, and so the Updates have appeared more frequently in recent years. The Update that follows concerns pertussis vaccine, and therefore, it supplements information in the 1982 edition of the Red Book. To place it in context, the entire Red Book section on Pertussis (pp 198 to 202) should be reviewed, as well as the general sections on immunization, particularly the section on Informed Consent (p 4) and the section on Vaccine Dose (p 10). Like many preventable childhood diseases, pertussis is now infrequently reported in this country. Although more than 200,000 cases were reported annually in the 1930s before pertussis vaccine was introduced, only about 2,000 cases are now recognized each year. The success of the vaccine has resulted in the remarkable decline of a formerly feared illness. As the incidence of the disease has declined, adverse reactions attributed to pertussis vaccine have received greater attention and prominence. In the United Kingdom, following Professor G. T. Stewart's alarming reports of brain damage due to pertussis vaccine, immunization rates fell profoundly, and as a result widespread outbreaks of pertussis began to occur.

The Future of Informed Consent in British Common Law

1999 ◽  
Vol 6 (3) ◽  
pp. 235-248 ◽  
Author(s):  
Keyword(s):  
Human Rights ◽  
United Kingdom ◽  
Informed Consent ◽  
Medical Profession ◽  
Common Law ◽  
European Convention ◽  
The United Kingdom ◽  
The Future ◽  
The Common ◽  
The Law

AbstractWithin the common law world, the use of the term informed consent implies the American doctrine. Informed consent as a doctrine is not part of the law in the United Kingdom. However, it is possible to predict a way forward in disclosure cases yet to be heard in the courts of the United Kingdom. These predictions are based on current developments in the common law in the United Kingdom as well as those in Canada and Australia, on the European convention on Human Rights and Biomedicine and on trends within the medical profession itself in the light of the Bolam test.

Longitudinal Study of Adverse Reactions Following Diphtheria-Tetanus-Pertussis Vaccine in Infancy

PEDIATRICS ◽  
1990 ◽  
Vol 85 (3) ◽  
pp. 294-302 ◽  
Author(s):  
Sarah S. Long ◽  
Adamadia Deforest ◽  
David Gary Smith ◽  
Carlos Lazaro ◽  
Steven G. F. Wassilak ◽  
...  
Keyword(s):  
Pertussis Vaccine ◽  
Adverse Reactions ◽  
Clinical Observation ◽  
Local Reaction ◽  
Vaccine Dose ◽  
Dose Schedule ◽  
Clinical Events ◽  
Dose Number ◽  
A Prospective Study ◽  
Antibody Levels

A prospective study of immunogenicity and adverse effects of 1553 doses of diphtheria and tetanus toxoids and whole cell pertussis vaccine (DTP) was performed in 538 children observed longitudinally from 2 months to 20 months of age. Subjects were randomized to the standard four-dose immunization schedule or to a three-dose schedule (with a saline injection substituted for DTP at 6 months of age). The three-dose schedule could not be recommended on the basis of serologic data. Compliance for completing a clinical observation form in the 48 hours following injections was >99%. Fever, local reactions, or adverse behavioral effects were described in association with 96% of DTP doses and 36% of placebo injections. Contraindications to DTP immunization developed in 3% of study children. No convulsion, hypotonic hyporesponsive episode, encephalopathy, or temperature >40.5°C occurred. Behavioral and local imflammatory effects occurred maximally in the first 6 hours following vaccine but fever peaked later. There was no interrelationship between occurrence of local reaction and fever. Data suggest that age has more effect on the type and rate of adverse clinical events than does vaccine dose number. Existing antibody levels to vaccine components, lot of vaccine, breast-feeding, or gestational age did not affect rate or type of clinical reactions. Neither occurrence of reactions nor the use of acetaminophen affected antibody response to vaccine.

Denial of Health Care and Informed Consent in English and American Law

1992 ◽  
Vol 18 (1-2) ◽  
pp. 37-71
Author(s):  
Frances H. Miller
Keyword(s):  
United States ◽  
Health Care ◽  
Informed Consent ◽  
The United States ◽  
Health Care Rationing ◽  
Legal Obligation ◽  
The United Kingdom ◽  
American Law ◽  
Care Rationing ◽  
Increased Pressure

Health care rationing has gained greater visibility in the United States and the United Kingdom, for quite different reasons. As patients in both countries become more aware that potentially beneficial medical services can be denied them on economic — as opposed to purely medical — grounds, they are beginning to seek help from the judiciary. This Article contends that as rationing becomes more explicit, the doctrine of informed consent will come under increased pressure. The Article suggests that courts and legislatures consider imposing a legal obligation on physicians to inform their patients when potentially effective treatment is to be withheld for economic or other non-clinical reasons.

Health care Online

2000 ◽  
Vol 1 (2) ◽  
pp. 24-25
Keyword(s):  
Health Care ◽  
Health Care Policy ◽  
Central Government ◽  
Medical Profession ◽  
Medical Opinion ◽  
Proactive Approach ◽  
The United Kingdom ◽  
Wide Range ◽  
On Line ◽  
The Subject

The BMJ has always been recognised as a leading medical journal for a wide range of subjects, and has always been useful for nurses to access for up to date and current medical opinion. Recently the BMJ has diversified to take on a more political nature, with its content reflecting a more proactive approach to influencing health care policy in the United Kingdom by the medical profession. As such the BMJ has become extremely useful for identifying opinions of current ‘hot topics’ for nurses that are headline news such as nurse consultants, hospital administration and central government policy. However, one problem remains, trying to find the original copy in the library will remain difficult. After spending the best part of an hour to suddenly realise that ‘how silly you are for not realising that BMJ March 1997 is filed in the British Journal of Nursing section 1998!!’ is often a frustrating and demoralising experience - particularly if after finding the article you find it has nothing to do with the subject that you are researching. This problem is to be banished forever with the BMJ website. The full BMJ is available free on line. The excellent search engine is particularly useful and is accurate when matching target articles. All articles are available for ‘full text’ downloads free of charge.

scholarly journals Evaluation of medicines advertising in medical journals

2009 ◽  
Vol 45 (2) ◽  
pp. 303-312
Author(s):  
Daliana Maria Berenice de Oliveira Souza ◽  
Suellen Cristiane Medeiros de Lima ◽  
Almária Mariz Batista ◽  
Maria Cleide Ribeiro Dantas de Carvalho
Keyword(s):  
Side Effects ◽  
Adverse Reactions ◽  
Healthcare Professionals ◽  
Scientific Information ◽  
Medical Prescription ◽  
Medical Journals ◽  
Registration Number ◽  
The Common

This work intended to analyze the advertising of medicines requiring medical prescription, divulged into three journals of the neurology and cardiology areas addressed to healthcare professionals. The analysis was based on current legislation, among other criteria, as well as specific literature. The presence of the following items was investigated: registration number, drug name, specific indications, contraindications; cautions and warnings; adverse reactions; possible side effects; posology; legibility of technical-scientific information and bibliographic references, phrases and/or expressions about the medication benefits, as compared to other drugs; safety warnings, healing promises and pictures of people smiling, and the quotations confirmation based on bibliographic references. Among the evaluated legal criteria, it was observed the absence of legibility in technical-scientific information in 85% of advertisements; absence of side effects in 23%; absence of cautions and warnings in 15%; of contraindications in 12.8%; of posology in 6.4%; of registration numbers in 2.7% and of the Common Brazilian Denomination/Common International Denomination (Denominação Comum Brasileira/Denominação Comum Internacional - DCB/DCI) in 0.6%. Out of 130 statements respecting advantages face to others drugs, 23.8% were not confirmed and out of 48 divulged safety messages, 41.7% could not be found in quoted references. The pictures of people smiling was a resource used in 42.2% of advertisements. Out of 1362 references analyzed, 19.7% were not found and 37.1% of quoted affirmations weren't confirmed.

Informed consent in psychiatric practice: where does the law now stand?

2011 ◽  
Vol 28 (2) ◽  
pp. 86-90
Author(s):  
Peter Leonard
Keyword(s):  
Informed Consent ◽  
Medical Profession ◽  
Case Law ◽  
Point Of View ◽  
Psychiatric Practice ◽  
Mental Health Legislation ◽  
Clinical Scenarios ◽  
Legal Duty ◽  
Legal Position ◽  
Health Legislation

AbstractThere is an established ethical and legal duty upon psychiatrists to obtain informed consent before treating a patient, although some exceptions do apply under Mental Health Legislation. The required standard for informed consent has been the subject of important case law in Ireland and other common law jurisdictions and this has caused some uncertainty for clinicians. The standard of informed consent can be viewed from the point of view of what the medical profession thinks is appropriate, or alternatively from the position of what a patient would reasonably expect to be told. These contrasting approaches are discussed in detail. A recent decision of the Irish Supreme Court establishes the ‘patient-centred’ standard for informed consent as the relevant standard in Irish law. The current legal position on informed consent is discussed in relation to common clinical scenarios in psychiatric practice.

DOES PERTUSSIS VACCINE CAUSE PERMANENT BRAIN DAMAGE? UNITED KINGDOM COURT RULES

PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. A54-A54
Author(s):  
Student
Keyword(s):  
United Kingdom ◽  
Young Children ◽  
Brain Damage ◽  
Pertussis Vaccine ◽  
Case Reports ◽  
Burden Of Proof ◽  
Medical Opinion ◽  
The United Kingdom ◽  
Neurologically Normal ◽  
Permanent Brain Damage

1. The preliminary issue to be determined by the court is, can pertussis vaccine cause permanent brain damage in young children? The question relates to pertussis vaccine manufactured in the United Kingdom and applies to all children whether or not they were neurologically normal before vaccination. The burden of proof rests on the Plaintiff and the standard of proof is that of the balance of probability. It must be shown that it is more likely than not that the vaccine can cause permanent brain damage. 2. The medical and expert opinion is deeply divided on the issue. 3. The question is not answered by showing that there is a respectable and responsible body of medical opinion that the vaccine can, albeit rarely, cause permanent brain damage, or that this view is/may be more widely held than the contrary. 4. Similarly the advice contained in the contra-indications against pertussis vaccination . . . cannot be relied upon as though it were evidence . . . that the vaccine in fact causes permanent brain damage. 5. Reports of . . . encephalopathy resulting in . . . brain damage or death where the onset occurs shortly after DTP vaccination, raises the hypothesis that the vaccine may cause brain damage or death. It does not prove the hypothesis. Such reports do not take account of events occurring by chance, for which no explanation can be found. What they do establish is that encephalopathy resulting occasionally in permanent brain damage or death does sometimes occur in close temporal proximity to pertussis vaccination. 6. I have reviewed the evidence and reasoning of the Plaintiffs and Defendants' expert witnesses . . . . I have found myself more impressed both by the cogency and quality of the evidence and reasoning of the experts called on behalf of the Defendants. 7. When I embarked on consideration of the preliminary issue, I was impressed by the case reports and what was evidently a widely held belief that the vaccination could, albeit rarely, cause permanent brain damage. I was ready to accept that this belief was well founded. But over the weeks that I have listened to and examined the evidence and arguments, I have become more and more doubtful that this is so. I have now come to the clear conclusion that the Plaintiff fails to satisfy me on the balance of probability that pertussis vaccine can cause permanent brain damage in young children. It is possible it does, the contrary cannot be proved. But in the result the Plaintiff's claim must fail.

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