<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1688-1249</journal-id>
<journal-title><![CDATA[Archivos de Pediatría del Uruguay]]></journal-title>
<abbrev-journal-title><![CDATA[Arch. Pediatr. Urug.]]></abbrev-journal-title>
<issn>1688-1249</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Uruguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1688-12492020000100029</article-id>
<article-id pub-id-type="doi">10.31134/ap.91.1.5</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Episodio de hipotonía-hiporreactividad como evento supuestamente atribuido a la vacunación e inmunización. Reporte de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Case study of a hypotonic-hyporesponsive episode from an alleged adverse effect following vaccination and immunization]]></article-title>
<article-title xml:lang="pt"><![CDATA[Relato de caso de episódio hipotônico hiporresponsivo supostamente atribuído a um evento adverso pós-vacinação e imunização]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arriola]]></surname>
<given-names><![CDATA[Andrea]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Romero]]></surname>
<given-names><![CDATA[Mario]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,ASSE Florida Pediatría ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<aff id="Af2">
<institution><![CDATA[,ASSE Florida Pediatría ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2020</year>
</pub-date>
<volume>91</volume>
<numero>1</numero>
<fpage>29</fpage>
<lpage>34</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_arttext&amp;pid=S1688-12492020000100029&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_abstract&amp;pid=S1688-12492020000100029&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.edu.uy/scielo.php?script=sci_pdf&amp;pid=S1688-12492020000100029&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen: El desarrollo de la vacunación a nivel mundial ha permitido el control de algunas enfermedades infecciosas, constituyéndose en una poderosa herramienta de salud pública. Asimismo, se han identificado algunos efectos secundarios neurológicos, como el denominado episodio de hipotonía-hiporreactividad, evento supuestamente atribuido a la vacunación e inmunización. Si bien es poco frecuente, se considera un efecto adverso severo. El objetivo de este artículo es reportar un caso y revisar la literatura sobre el tema. Se presenta una lactante de 2 meses que luego de tres horas de recibir la primera dosis de la vacuna combinada pentavalente, presenta episodio de hipotonía con cianosis de segundos de duración. Este episodio se caracteriza por presentarse horas después de la administración de la vacuna con un inicio súbito de hipotonía generalizada, hiporreactividad y palidez cutánea o cianosis. El diagnóstico es de exclusión, ya que se presenta en lactante de aspecto grave. La mayoría de los episodios se han relacionado con el componente pertussis, ya sea celular o acelular. La vigilancia de los ESAVI es un pilar fundamental para desarrollar esquemas de vacunación eficaces y seguros para toda la población.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Summary: The global development of vaccines has enabled us to control some infectious diseases and has become a powerful public health tool. Despite this, vaccines have some neurological side effects, such as the so-called Hypotonic-Hyporesponsive Episode (HHE), an adverse event following vaccination and immunization (AEFI). Even though it is rare, it is considered to be a severe adverse effect. The objective of this article is to report about a HHE case and to review the literature on the subject. The case is of a 2-month-old infant who, after 3 hours of receiving the first dose of the combined pentavalent vaccine, developed a hypotonic episode with cyanosis of seconds of duration. HHE usually happens hours after the vaccine is administered and it shows a sudden onset of generalized hypotonia, hyporesponsiveness, pale skin or cyanosis. A diagnosis of exclusion was made, since the symptoms looked serious on the infant. Most episodes have been linked to cellular or acellular pertussis. It is essential to carry out AEFI surveillance in order to develop effective and safe vaccination schedules for the entire population.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo: O desenvolvimento global de vacinas há permitido controlar algumas doenças infeccionas tornando-se uma poderosa ferramenta de saúde pública. Apesar disso, elas têm alguns efeitos colaterais neurológicos, como o chamado Episódio Hipotônico-Hiporresponsivo (EHH), um evento adverso pós-vacinação e imunização (EAPV). Embora seja raro, é considerado um efeito adverso grave. O objetivo deste artigo é relatar um caso de EHH e revisar a literatura sobre o assunto. O relato de caso é de uma criança de 2 meses de idade quem, após 3 horas de recebimento da primeira dose da vacina pentavalente combinada, desenvolveu um episódio hipotônico com cianose de segundos de duração. O EHH geralmente ocorre horas após a administração da vacina e mostra um início repentino de hipotonia generalizada, hiporresponsividade, pele pálida ou cianose. O diagnóstico foi de exclusão, pois os sintomas no bebê eram sérios. A maioria dos episódios foi associada à pertussis celular ou acelular. É essencial realizar a vigilância da EAPV para desenvolver cronogramas de vacinação eficazes e seguros para toda a população.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Vacunación]]></kwd>
<kwd lng="es"><![CDATA[Episodio hipotonía-hiporreactividad]]></kwd>
<kwd lng="es"><![CDATA[Vacuna contra la tos ferina]]></kwd>
<kwd lng="en"><![CDATA[Vaccination]]></kwd>
<kwd lng="en"><![CDATA[Hypotonic-hyporesponsive episode]]></kwd>
<kwd lng="en"><![CDATA[Pertussis vaccine]]></kwd>
<kwd lng="pt"><![CDATA[Vacinação]]></kwd>
<kwd lng="pt"><![CDATA[Episódio de hipotonia e hiperacatividade]]></kwd>
<kwd lng="pt"><![CDATA[Vacina contra coqueluche]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="book">
<collab>American Academy of Pediatrics</collab>
<article-title xml:lang=""><![CDATA[Active and passive immunization]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kimberlin]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Brady]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Jackson]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Long]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Red book: 2015 report of the Committee on Infectious Diseases]]></source>
<year>2015</year>
<edition>30</edition>
<page-range>1-107</page-range><publisher-loc><![CDATA[Elk Grove Village, IL ]]></publisher-loc>
<publisher-name><![CDATA[American Academy of Pediatrics]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="book">
<collab>Australian Technical Advisory Group on Immunisation</collab>
<article-title xml:lang=""><![CDATA[Fundamentals of immunisation]]></article-title>
<collab>Australian Government. Department of Health</collab>
<source><![CDATA[Australian immunization handbook]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Canberra ]]></publisher-loc>
<publisher-name><![CDATA[ATAGI]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="book">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ezeanolue]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Harriman]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Hunter]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Kroger]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Pellegrini]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<source><![CDATA[General best practice guidelines for immunization: best practices guidance of the Advisory Committee on Immunization Practices (ACIP).]]></source>
<year>2016</year>
<publisher-loc><![CDATA[Atlanta, GA ]]></publisher-loc>
<publisher-name><![CDATA[CDC]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="">
<collab>Organización Mundial de la Salud</collab>
<article-title xml:lang=""><![CDATA[Plan de acción mundial sobre vacunas]]></article-title>
<source><![CDATA[65ª Asamblea Mundial de la Salud.]]></source>
<year>2012</year>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud</collab>
<source><![CDATA[Vigilancia de efectos adversos supuestamente atribuibles a la vacunación]]></source>
<year>2013</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud</collab>
<collab>Unidad de Inmunizaciones</collab>
<collab>División Epidemiología - Unidad de Farmacovigilancia</collab>
<collab>Departamento de Medicamentos</collab>
<collab>División Evaluación Sanitaria</collab>
<source><![CDATA[Informe del sistema notificación de efectos adversos supuestamente atribuibles a la vacunación o inmunización. Año 2018]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="book">
<collab>Centers for Disease Control and Prevention</collab>
<article-title xml:lang=""><![CDATA[Pertussis]]></article-title>
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hamborsky]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Kroger]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Wolfe]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<source><![CDATA[Epidemiology and prevention of vaccine-preventable diseases]]></source>
<year>2015</year>
<edition>13</edition>
<publisher-loc><![CDATA[Washington, DC ]]></publisher-loc>
<publisher-name><![CDATA[Public Health Foundation]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Buettcher]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Heininger]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Braun]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bonhoeffer]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Halperin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Heijbel]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypotonic-hyporesponsive episode (HHE) as an adverse event following immunization in early childhood case definition and guidelines for data collection, analysis, and presentation]]></article-title>
<source><![CDATA[Vaccine]]></source>
<year>2007</year>
<volume>25</volume>
<numero>31</numero>
<issue>31</issue>
<page-range>5875-81</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<collab>World Health Organization</collab>
<article-title xml:lang=""><![CDATA[Pertussis vaccines: WHO position paper - September 2015]]></article-title>
<source><![CDATA[Wkly Epidemiol Rec]]></source>
<year>2015</year>
<volume>90</volume>
<page-range>433-60</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud</collab>
<source><![CDATA[Esquema de vacunación vigente]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="book">
<collab>Ministerio de Salud</collab>
<source><![CDATA[Guía nacional de vacunación en situaciones especiales]]></source>
<year>2018</year>
<publisher-loc><![CDATA[Montevideo ]]></publisher-loc>
<publisher-name><![CDATA[MS]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="book">
<collab>Brighton Collaboration</collab>
<collab>Grupo de Trabajo sobre el EHH</collab>
<source><![CDATA[El episodio hipotónico-hiporreactivo (EHH) como evento adverso después de la inmunización: definición de caso y guías para la recogida, análisis y presentación de datos.]]></source>
<year>2003</year>
<publisher-loc><![CDATA[Basilea, Suiza ]]></publisher-loc>
<publisher-name><![CDATA[Brighton Collaboration]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Monteiro]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Takano]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Waldman]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surveillance for adverse events after DTwP/Hib vaccination in Brazil sensitivity and factors associated with reporting]]></article-title>
<source><![CDATA[Vaccine]]></source>
<year>2010</year>
<volume>28</volume>
<numero>18</numero>
<issue>18</issue>
<page-range>3127-33</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Galindo Santana]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Galindo Sardiña]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Episodio de hipotonía e hiporreactividad posterior a la aplicación de vacunas en Cuba durante el período 2012-2013]]></article-title>
<source><![CDATA[Rev Cuba Med Trop]]></source>
<year>2015</year>
<volume>67</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>1-12</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Braun]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Terracciano]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Salive]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Blumberg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Vermeer-de Bondt]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Heijbel]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Report of a US public health service workshop on hypotonic-hyporesponsive episode (HHE) after pertussis immunization]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>1998</year>
<volume>102</volume>
<numero>5</numero>
<issue>5</issue>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[DuVernoy]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Braun]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypotonic-hyporesponsive episodes reported to the Vaccine Adverse Event Reporting System (VAERS), 1996-1998]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>2000</year>
<volume>106</volume>
<numero>4</numero>
<issue>4</issue>
</nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schmitt]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Schuind]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Knuf]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Beutel]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Schulte-Wissermann]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Gahr]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical experience of a tricomponent acellular pertussis vaccine combined with diphtheria and tetanus toxoids for primary vaccination in 22,505 infants]]></article-title>
<source><![CDATA[J Pediatr]]></source>
<year>1996</year>
<volume>129</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>695-701</page-range></nlm-citation>
</ref>
<ref id="B18">
<label>18</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gold]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Kempe]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Osbourn]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A comparison of serious adverse reactions to whole cell and acellular pertussis vaccines in South Australia]]></article-title>
<source><![CDATA[Med J Aust]]></source>
<year>1999</year>
<volume>171</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>331-2</page-range></nlm-citation>
</ref>
<ref id="B19">
<label>19</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Miller]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Overview of recent clinical trials of acellular pertussis vaccines]]></article-title>
<source><![CDATA[Biologicals]]></source>
<year>1999</year>
<volume>27</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>79-86</page-range></nlm-citation>
</ref>
<ref id="B20">
<label>20</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Díaz Morales]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Martínez Pajares]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Trigo Moreno]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Ramos Díaz]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Episodio de hipotonía-hiporreactividad posvacunación con DTPa]]></article-title>
<source><![CDATA[Arch Argent Pediatr]]></source>
<year>2013</year>
<volume>111</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>e97-100</page-range></nlm-citation>
</ref>
<ref id="B21">
<label>21</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Velasco]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Montero]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Guzmán]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Episodio hipotonía-hiporreactividad posterior a la inmunización con vacuna combinada con pertussis de células enteras reporte de un caso]]></article-title>
<source><![CDATA[Rev Chil Pediatr]]></source>
<year>2017</year>
<volume>88</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>771-5</page-range></nlm-citation>
</ref>
<ref id="B22">
<label>22</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vermeer]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Dzaferagiæ]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[David]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Performance of the Brighton collaboration case definition for hypotonic-hyporesponsive episode (HHE) on reported collapse reactions following infant vaccinations in the Netherlands]]></article-title>
<collab>van der Maas N</collab>
<source><![CDATA[Vaccine]]></source>
<year>2006</year>
<volume>24</volume>
<numero>49-50</numero>
<issue>49-50</issue>
<page-range>7066-70</page-range></nlm-citation>
</ref>
<ref id="B23">
<label>23</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jefferson]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Rudin]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[DiPietrantonj]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Systematic review of the effects of pertussis vaccines in children]]></article-title>
<source><![CDATA[Vaccine]]></source>
<year>2003</year>
<volume>21</volume>
<numero>17-18</numero>
<issue>17-18</issue>
<page-range>2003-14</page-range></nlm-citation>
</ref>
<ref id="B24">
<label>24</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Baraff]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Shields]]></surname>
<given-names><![CDATA[W]]></given-names>
</name>
<name>
<surname><![CDATA[Beckwith]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Strome]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Marcy]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Cherry]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Infants and children with convulsions and hypotonic-hyporesponsive episodes following diphtheria-tetanus-pertussis immunization follow-up evaluation]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>1988</year>
<volume>81</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>789-94</page-range></nlm-citation>
</ref>
<ref id="B25">
<label>25</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Gold]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Scheifele]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Halperin]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Déry]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Law]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Lebel]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypotonic-hyporesponsive episodes in children hospitalized at 10 Canadian Pediatric Tertiary-Care Centres, 1991-1994]]></article-title>
<source><![CDATA[Can Commun Dis Rep]]></source>
<year>1997</year>
<volume>23</volume>
<numero>10</numero>
<issue>10</issue>
<page-range>73-6</page-range></nlm-citation>
</ref>
<ref id="B26">
<label>26</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Blumberg]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Lewis]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Mink]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Christenson]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Chatfield]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Cherry]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Severe reactions associated with diphtheria-tetanus-pertussis vaccine detailed study of children with seizures, hypotonic-hyporesponsive episodes, high fevers, and persistent crying]]></article-title>
<source><![CDATA[Pediatrics]]></source>
<year>1993</year>
<volume>91</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>1158-65</page-range></nlm-citation>
</ref>
<ref id="B27">
<label>27</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rodríguez]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Zunino]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Speranza]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Fernández]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Varela]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Picón]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Seguimiento de eventos supuestamente atribuibles a la vacunación e inmunización (ESAVI) graves notificados al Ministerio de Salud Pública entre 2010 y 2014]]></article-title>
<source><![CDATA[Rev Méd Urug]]></source>
<year>2017</year>
<volume>33</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>47-58</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
