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Adverse events extremely rare after reimmunization in children
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Among children who experienced adverse events following vaccination, the risk of recurrence of serious adverse events — including anaphylaxis, apnea or seizures — when revaccinated was less than 1%, according to a study published in Pediatrics.
“Vaccine recipients who experienced an adverse event following immunization are sometimes afraid that the adverse event might recur with future immunizations,” Joseline Guetsop Zafack, MD, MPH, from the department of social and preventive medicine at Laval University, Quebec, and colleagues wrote. “Most existing recommendations regarding the management of patients who had an adverse event are based on expert opinion and supported by limited scientific data.”
To review the available literature concerning adverse events following immunization (AEFI), the researchers gathered articles written in English or French that were published before Sept. 30, 2016. All studies included must have analyzed the risk of AEFI in at least five individuals who were not administered experimental vaccines.
Of the 29 articles included in the analysis, patients were recorded as having a history of hypotonic hyporesponsive episode (n = 398), anaphylaxis (n = 133) or seizures (n = 60). For these patients who were reimmunized, 0% to 0.8% experienced AEFI, with events appearing allergic in 30 of the 594 patients. A wide range was noted in the number of patients who had recurring fever (0% to 84% of 836 patients). This percentage varied by the vaccine and dose number.
The recurrence of extensive leg swelling after the fourth dose of diphtheria-tetanus-acellular pertussis vaccine was higher if the fifth dose was administered with the full-antigen formulation (78%) rather than the reduced-antigen formulation (53%, P = .02).
“There was great variability in the management of patients with allergic-like events after immunization,” Zafack and colleagues wrote. “There may be a need for guidelines to be evaluated and validated to standardize practices.” – by Katherine Bortz
Disclosure: De Serres has received investigator-initiated grants from GlaxoSmithKline and Pfizer and travel reimbursement to attend an ad hoc advisory board meeting of GlaxoSmithKline; Top has received in-kind research support from Pzifer and a grant from GlaxoSmithKline. The other authors have no potential conflicts of interest to disclose.
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