No abstract

Introduction: The measles outbreak registered in Brazil in 2018, forced the alteration of preventive actions for the disease, leading to the addition of the zero dose of the Triple Viral vaccine for children from 6 months of age to 11 months and 29 days. The zero dose precedes the first dose, but does not exclude its mandatory nature. Studies that address the harms and benefits of the extra early dose are scarce. This study aimed to point out the pros and cons of zero dose management in light of the report of an adverse hypersensitivity reaction to this dose of the Triple Viral vaccine. Case report: Male patient, 6 months old, attended the childcare consultation to investigate a possible hypersensitivity reaction after administration of the zero dose of the Triple Viral vaccine. On physical examination, he showed good general condition, development compatible with age and generalized hypersensitivity. Discussion: It addresses the importance of the Triple Viral Vaccine and raises the question of few studies about the consequences of the new vaccine protocol, which recommends the administration of zero dose in children under one year old, in the face of the measles outbreak. Conclusion: The Triple Viral vaccine is an efficient mechanism to fight measles. The benefits outweigh the adverse effects of the vaccine, however, further studies are needed in order to understand the real consequences of administering the zero dose to children under one year of age.

Abstract. To determine whether the slope of a maximal bronchial challenge test (in which FEV 1 falls by over 50%) could be extrapolated from a standard bronchial challenge test (in which FEV 1 falls up to 20%), 14 asthmatic children performed a single maximal bronchial challenge test with methacholine (dose range: 0.097-30.08 mol) by the dosimeter method. Maximal dose-response curves were included according to the following criteria: (1) at least one more dose beyond a ⌬FEV 1 ജ 20%; and (2) a MFEV 1 ജ 50%. PD 20 FEV 1 was calculated, and the slopes of the early part of the dose-response curve (standard dose-response slopes) and of the entire curve (maximal dose-response slopes) were calculated by two methods: the two-point slope (DRR) and the least squares method (LSS) in % ⌬FEV 1 × mol −1 . Maximal dose-response slopes were compared with the corresponding standard dose-response slopes by a paired Student's t test after logarithmic transformation of the data; the goodness of fit of the LSS was also determined. Maximal dose-response slopes were significantly different (p < 0.0001) from those calculated on the early part of the curve: DRR 20% (91.2 ± 2.7 ⌬FEV 1 % ⅐ mol −1 ) was 2.88 times higher than DRR 50% (31.6 ± 3.4 ⌬FEV 1 % ⅐ mol −1 ), and the LSS 20% (89.1 ± 2.8% ⌬FEV 1 ⅐ mol −1 ) was 3.10 times higher than LSS 50% (28.8 ± 1.5% ⌬FEV 1 ⅐ mol −1 ). The goodness of fit of LSS 50% was significant in all cases, whereas LSS 20% failed to be significant in one. These results suggest that maximal dose-response slopes cannot be predicted from the data of standard bronchial challenge tests.