The role of whole-cell pertussis vaccine as a cause of permanent neurologic damage has been reassessed by the American Academy of Pediatrics, Committee on Infectious Diseases, in light of new 10-year follow-up findings of the National Childhood Encephalopathy Study (NCES) in Great Britain. Although causal relationship is not definitely acknowledged, the committee now concludes that DTP vaccination can be associated with chronic neurologic dysfunction in children who had severe acute neurologic illnesses after DTP vaccination. The immunization guidelines in the 1994 Red Book continue to be recommended, but specific guidelines for acellular pertussis vaccines will be revised after FDA approval of new products. 
COMMENT. Pediatric neurologists caring for patients with increased susceptibility to precipitation or exacerbation of neurologic disorders such as seizures, behavior disorders, or language and developmental delays should use caution in advising parents concerning risks of immunizations. The AAP committee is careful to qualify their recommendations by a disclaimer rider.
Varicella vaccine-induced acute cerebellar ataxia is reported for the first time, affecting a 2-year-old boy who developed vomiting and ataxia 10 days after vaccination. MRI showed multiple demyelinating lesions. Recovery followed in 3 weeks.