{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:08:55Z","timestamp":1777417735776,"version":"3.51.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2002,5,1]],"date-time":"2002-05-01T00:00:00Z","timestamp":1020211200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2002,5]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>A previous study suggested that high concentrations of endotoxin may be present in whole-cell diphtheria\/tetanus\/pertussis (DTP) vaccine, and the scientific literature contains many studies examining the reactivity of whole-cell DTP vaccine. The medical and scientific communities have previously reported that the presence of endotoxin in commercial vaccines may have negative effects on vaccine recipients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To determine the endotoxin concentrations in whole-cell DTP, acellular DTP (DTaP), and DT vaccines and determine the clinical experience with each vaccine.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>To study the endotoxin concentrations in vaccines, the Limulus amebocyte lysate (LAL) assay was used. The vaccines analyzed with the LAL assay were whole-cell DTP vaccine lots manufactured by Connaught, Lederle, the Michigan and Massachusetts Departments of Health, and Wyeth; DTaP vaccine lots manufactured by Merieux and Takeda; and DT vaccine lots manufactured by Wyeth and Lederle. The incidence of adverse reactions following whole-cell DTP, DTaP, and DT vaccines were determined based on analysis of the Vaccine Adverse Events Reporting System (VAERS) database.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The results of the LAL assay showed that whole-cell DTP vaccines contained considerably more endotoxin than either DTaP or DT vaccines. The VAERS showed that statistically significantly more adverse reactions were associated with whole-cell DTP vaccine than DTaP or DT vaccines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This analysis confirmed higher concentrations of endotoxin in whole-cell DTP vaccines compared with DTaP or DT vaccines. As high concentrations of endotoxin may be correlated with a higher incidence of adverse events, the switch from whole-cell DTP to DTaP for routine vaccinations in the US seems well justified.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1a410","type":"journal-article","created":{"date-parts":[[2003,6,4]],"date-time":"2003-06-04T16:20:48Z","timestamp":1054743648000},"page":"776-780","source":"Crossref","is-referenced-by-count":16,"title":["Clinical Implications of Endotoxin Concentrations in Vaccines"],"prefix":"10.1177","volume":"36","author":[{"given":"David A","family":"Geier","sequence":"first","affiliation":[{"name":"David A Geier, President, MedCon, Inc., Silver Spring, MD"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark R","family":"Geier","sequence":"additional","affiliation":[{"name":"Mark R Geier MD PhD, President, The Genetic Centers of America, Silver Spring"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2002,5,1]]},"reference":[{"key":"bibr-bibr1-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.36.3.445-449.1978"},{"key":"bibr-bibr2-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1093\/jhmas\/57.3.249"},{"key":"bibr-bibr3-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1542\/peds.16.5.637"},{"key":"bibr-bibr4-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5207.1184"},{"key":"bibr-bibr5-aph.1A410","first-page":"55","volume":"117","author":"Haire M","year":"1967","journal-title":"The Medical Officer"},{"key":"bibr-bibr6-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1136\/adc.49.1.46"},{"key":"bibr-bibr7-aph.1A410","first-page":"1965","volume":"110","author":"Bajc OTS","year":"1971","journal-title":"Schweiz Med Wschr"},{"key":"bibr-bibr8-aph.1A410","doi-asserted-by":"crossref","first-page":"A169","DOI":"10.1212\/WNL.32.2.169","volume":"32","author":"Torch WC","year":"1982","journal-title":"Neurology"},{"key":"bibr-bibr9-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1097\/00006454-198409000-00019"},{"key":"bibr-bibr10-aph.1A410","volume-title":"New vaccine development: establishing priorities","author":"US Institute of Medicine","year":"1985"},{"key":"bibr-bibr11-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1016\/0092-1157(88)90018-2"},{"key":"bibr-bibr12-aph.1A410","volume-title":"Adverse effects of pertussis and rubella vaccines","author":"US Institute of Medicine","year":"1991"},{"key":"bibr-bibr13-aph.1A410","unstructured":"Alderslade R, Bellman MH, Rawson NSB, Ross EM. Whooping cough. London: HM Stationary Office, 1981: 79\u2013169."},{"key":"bibr-bibr14-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.307.6913.1171"},{"key":"bibr-bibr15-aph.1A410","volume-title":"DPT vaccine and chronic nervous system dysfunction: a new analysis","author":"US Institute of Medicine","year":"1994"},{"key":"bibr-bibr16-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1542\/peds.106.4.e51"},{"key":"bibr-bibr17-aph.1A410","first-page":"37","volume":"48","author":"Geier MR","year":"2001","journal-title":"Hepatogastroenterology"},{"key":"bibr-bibr18-aph.1A410","first-page":"789","volume":"18","author":"Geier MR","year":"2000","journal-title":"Clin Exp Rheumatol"},{"key":"bibr-bibr19-aph.1A410","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-134-12-200106190-00030"},{"key":"bibr-bibr20-aph.1A410","unstructured":"Geier DA, Geier MR. Hepatitis B vaccination and adult associated gastrointestinal reactions: A followup analysis. 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Texas Med (in press 2002)."},{"key":"bibr-bibr25-aph.1A410","first-page":"724","volume":"19","author":"Geier DA","year":"2001","journal-title":"Clin Exp Rheumatol"},{"key":"bibr-bibr26-aph.1A410","volume":"20","author":"Geier DA","year":"2002","journal-title":"Clin Exp Rheumatol"},{"key":"bibr-bibr27-aph.1A410","first-page":"631","volume":"34","author":"Eckman PL","year":"1958","journal-title":"Am J Pathol"},{"key":"bibr-bibr28-aph.1A410","doi-asserted-by":"publisher","DOI":"10.7883\/yoken1952.38.53"},{"key":"bibr-bibr29-aph.1A410","first-page":"277","volume":"23","author":"Homma R","year":"1970","journal-title":"Jpn J Med Sci Biol"},{"key":"bibr-bibr30-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(75)90076-7"},{"key":"bibr-bibr31-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1016\/0008-8749(82)90457-9"},{"key":"bibr-bibr32-aph.1A410","doi-asserted-by":"publisher","DOI":"10.1016\/0264-410X(89)90236-3"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1A410","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1A410","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:05:38Z","timestamp":1777374338000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1A410"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002,5]]},"references-count":32,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2002,5]]}},"alternative-id":["10.1345\/aph.1A410"],"URL":"https:\/\/doi.org\/10.1345\/aph.1a410","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2002,5]]}}}