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GPs given wrong advice on vaccine adverse reactions

NHS officials charged with advising GPs on immunisation have no consistent policy on how to manage adverse reactions to routine childhood vaccines, a major study reveals.

Some tell GPs to omit pertussis from the second and third dose of DTP/Hib in any baby who had an adverse reaction to the first dose, in breach of Government guidance.

The study leaders, from the Government's Health Protection Agency and the University of Manchester, said the results were 'entirely depressing'.

They questioned 134 expert advisers to district immunisation co-ordinators on how they would manage future vaccinations in a child who suffered a local reaction, fever, convulsion or collapse following DTP/Hib, meningitis C and polio vaccines.

The results highlighted a dramatic lack of consensus.

Some 57 per cent said they would switch from whole cell to acellular pertussis vaccine in any child who had a local reaction to the first dose, with the rest either continuing immunisations as normal, delaying further doses or giving vaccines at separate body sites.

There was least agreement in the case of a collapse or

hypotonic-hyporesponsive ep-isode, where 38 per cent opted for acellular pertussis and 27 per cent for omitting pertussis, according to results presented to a Royal College of Paediatrics and Child Health conference in York this month.

Study author Dr David Baxter, consultant in communicable disease control at Stockport PCT, said: 'The most dangerous thing in the world is to give an opinion not based on fact or evidence.'

Dr Nicol Black, communicable disease control co-ordinator at north of Tyne local health protection unit, said: 'The consensus on which option to choose is not there. But the overriding objective is to prevent a child having disease ­ not immunising should not be an option.'

GPs should always consider how they could continue to vaccinate, possibly by delaying further vaccinations, he added.

RCGP immunisation spok-esman Dr George Kassianos, a GP in Bracknell, Berkshire, urged GPs to follow Department of Health 'green book' guidelines, which state acellular DTP should be used in the case of a severe reaction to whole-cell vaccine.

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