Association between immunization coverage and atopy in children with or without family history of atopic disease

  • Isabella Riandani
  • Budi Setiabudiawan
  • Cissy B. Kartasasmita
Keywords: atopy, immunization, total serum IgE, family history of atopic disease


Background Atopic diseases are determined by the interaction
between genetic and environmental factors. The possible effects
of immunization, as one of environmental factors, on atopy remain
a matter of controversy.
Objective We conducted an observational clinical epidemiology
to find out the protective effect of high vaccination coverage to
atopy in children.
Methods During January through March 2006, 150 of749 children
at Garuda, Padasuka, and Babakan Sari Primary Health Care in
Bandung were randomized from group with and without family
history of atopic disease. Atopy derived from skin prick test and
total serum lgE was evaluated. Atopy was defined as a positive
skin test to any of the eight allergens tested. The immunizations
were recorded from Kartu Menuju Sehat (KMS). Statistical analyses
included Chi square to compare prevalence, independent T-test
and Mann-Whitney to compare mean.
Results Atopy was found in 28.2% of284 subjects, of which 32.4%
with and 23.9% without a family history of atopic disease. The
median of total serum lgE level was higher in children with family
history of atopic disease and in atopy children. Children were
grouped according to total dose of basic immunizations (0-17 and
2: 18) based on Program Pengembangan Imunisasi (PPI). There was
nonsignificant association between total doses of immunization
and atopy. Even though no statistically significant, the cumulative
immunization doses were inversely related to the median of total
serum IgE level.
Conclusions The immunization coverage has not decreased atopy

Author Biographies

Isabella Riandani
Department of Child Health, Medical School, Padjadjaran
University, Hasan Sadikin General Hospital, Bandung, Indonesia.
Budi Setiabudiawan
Department of Child Health, Medical School, Padjadjaran
University, Hasan Sadikin General Hospital, Bandung, Indonesia.
Cissy B. Kartasasmita
Department of Child Health, Medical School, Padjadjaran
University, Hasan Sadikin General Hospital, Bandung, Indonesia.


1. Kay AB. Allergy and allergic diseases. N Eng J Med.
2001 ;344(1):30-7.
2. Gold MS, Kemp AS. Atopic disease in childhood. MJA.
2005; 182(1):298-304.
3. ISAAC. Worldwide variations in the prevalence of asthma
symptoms: the International Study of Asthma and Allergies
in Childhood (ISAAC). Eur Respir J. 1998; 12:315-35.
4. Weinberg EG. Urbanization and childhood asthma in South
Africa. ACI International. 2000;Sl:39-42.
5. Kjellman NIM. Prediction and prevention of atopic allergy.
In: Hamsten MVH, Wickman M, editors. 30 years with IgE.
Copenhagen: Munksgaard, 2000; p. 73-7.
6. Alford HS, Zoratti E, Peterson EL, Maliarik M, Ownby
DR, Johnson CC. Parental history of atopic disease: disease
pattern and risk of pediatric atopy in offspring. J Allergy Clin
Immunol. 2004; 114:1046-50.
7. Strachan DP. Family size, infection and atopy: the first decade
of the hygiene hypothesis. Thorax. 2000;55(S1):2-10.
8. Wahn U, von Mutius E. Childhood risk factors for atopy and
the importance of early intervention. J Allergy Clin Immunol.
2001; 107:567-74.
9. Savelkoul HFJ, Neijens HJ. Immune responses during
allergic sensitization and the development of atopy. Allergy.
10. Holt PG, Rudin A, Macau bas C, Holt BJ, Rowe J, Loh R, et al.
Development of immunologic memory against tetanus toxoid
and pertactin antigens from the diphtheria-tetanus-pertussis
vaccine in atopic versus nonatopic children. J Allergy Clin
Immunol. 2000; 105: 111 7-22.
11. Wills-Karp M, Santeliz J, Karp CL. The germless theory of
allergic disease: revisiting the hygiene hypothesis. Nature
Reviews. 2001;1:69-75.
12. Anderson HR, Poloniecki JD, Strachan DP, Beasley R,
Bji:irksten B, Asher MI. Immunization and symptoms of atopic
disease in children: results from the International Study of
Asthma and Allergies in Childhood. Am J Public Health.
2001;91 (7): 1126-9.
13. Nilsson L, Kjellman M, Bji:irksten B. A randomized controlled
trial of the effect of pertussis vaccines on atopic disease. Arch
Pediatr Adolesc Med. 1998;152:734-8.
14. Nilsson L, Kjellman M, Bji:irksten B. Allergic disease at the
age of 7 years after pertussis vaccination in infancy. Arch
Pediatr Adolesc Med. 2003;157:1184-9.
15. Maitra A, Shrriff A, Griffiths M, Henderson J. Pertussis
vaccination in infancy and asthma or allergy in later
childhood: birth cohort study. BMJ. 2004;328:925-6.
16. McKeever T, Lewis SA, Smith C, Hubbard R. Vaccination
and allergic disease: a birth cohort study. Am J Public Health.
17. Kristensen I, Aaby P, Jensen H. Routine vaccinations and
child survival: follow up study in Guinea-Bissau, West Africa.
BMJ. 2000;321:1-8.
18. Gruber C, Illi S, Lau S, Nickel R, Forster J, Kamin W, et al.
Transient suppression of atopy in early childhood is associated
with high vaccination coverage. Pediatrics. 2003; 111:282-8.
19. Bernsen RMD, de Jongste JC, van der Wouden JC. Lower
risk of atopic disorders in whole cell pertussis-vaccinated
children. Eur Respir J. 2003;22:962-4.
20. von Hertzen LC, Haahtela T. Immunization and atopy:
possible implications of ethnicity. J Allergy Clin Immunol.
2004; 113:401-6.
21. Odent MR, Culpin EE, Kimmel T. Pertussis vaccination and
asthma: is there a link? JAMA. 1994;272(8):592-3.
22. Henderson J, North K, Griffiths M, Harvey I, Golding J.
Pertussis vaccination and wheezing illnesses in young children:
prospective cohort study. BMJ. 1999;318: 117 3-6.
23. Paunio M, Heinonen OP, Virtanen M, Leinikki P, Patja
A, Peltola H. Measles history and atopic diseases. JAMA.
24. Hurwitz EL, Morgenstern H. Effects of Diphtheria-
Tetanus-Pertussis or Tetanus vaccination on allergies and
allergy-related respiratory symptoms among children and
adolescents in the United States. J Manipulative Physiol
Ther. 2000;23(2):81-90.
25. Koning H, Baert MRM, Oranje AP, Savelkoul HFJ, Neijens
HJ. Development of immune functions, related to allergic
mechanism, in young children. In: Koning H, editor. T and B cell
activation in childhood allergy. Rotterdam, 1996; p. 11-30.
26. Yunginger JW. Clinical significance of IgE. In: Middleton
E, Reed CE, Ellis EF, Adkinson NF, Yunginger JW, editors.
Allergy: principles and practice. 3th ed. Toronto: CV Mosby
Company, 1988; p. 849-57.
27. Bjorksten B. The intrauterine and postnatal environments.
J AllergyClinimmunol. 1999;104:1119-27.
28. Johansson SGO, Bieber T, Dahl R, Friedmann PS, Lanier
BQ, Lockey RF, et al. Revised nomenclature for allergy for
global use: report of the nomenclature review committee of
the world allergy organization, October 2003. J Allergy Clin
lmmunol. 2004; 113:832-6.
29. Beltrani VS, Boguneiwicz M. Atopic dermatitis. Dermatology
Online Journal 2003;9(2). Available from: http: //www. 7.
30. Koppen S, de Groot R, Neijens HJ, Nagelkerke N, van Eden W,
Rumke HC. No epidemiological evidence for infant vaccinations
to cause allergic disease. Vaccine. 2004;22:3375-85.
31. Umetsu DT, Akbari 0, DeKruyff RH. Regulatory T cells
control the development of allergic diasease and asthma. J
Allergy Clin lmmunol. 2003; 112:480-7.
How to Cite
Riandani I, Setiabudiawan B, Kartasasmita C. Association between immunization coverage and atopy in children with or without family history of atopic disease. PI [Internet]. 15Sep.2016 [cited 28May2024];48(6):358-3. Available from:
Received 2016-09-14
Accepted 2016-09-14
Published 2016-09-15