Rate of Recurrence of Adverse Events Following Immunization: Results of 19 Years of Surveillance in Quebec, Canada

Joseline G. Zafack, Eveline Toth, Monique Landry, Jean Philippe Drolet, Karina A. Top, Gaston De Serres

Producción científica: Contribución a una revistaArtículorevisión exhaustiva

8 Citas (Scopus)

Resumen

Background: While adverse events following immunization (AEFI) are frequent, there are limited data on the safety of reimmunizing patients who had a prior AEFI. Our objective was to estimate the rate and severity of AEFI recurrences. Methods: We analyzed data from the AEFI passive surveillance system in Quebec, Canada, that collects information on reimmunization of patients who had a prior AEFI. Patients with an initial AEFI reported to the surveillance system between 1998 and 2016 were included. Rate of AEFI recurrence was calculated as number of patients with recurrence/total number of patients reimmunized. Results: Overall, 1350 patients were reimmunized, of which 59% were 2 years of age or younger. The AEFI recurred in 16% (215/1350) of patients, of whom 18% (42/215) rated the recurrence as more severe than the initial AEFI. Large local reactions extending beyond the nearest joint and lasting 4 days or more had the highest recurrence rate (67%, 6/9). Patients with hypotonic hyporesponsive episodes had the lowest rate of recurrence (2%, 1/50). Allergic-like events recurred in 12% (76/659) of patients, but none developed anaphylaxis. Of 33 patients with seizures following measles mumps rubella with/without varicella vaccine, none had a recurrence. Compared with patients with nonserious AEFIs, those with serious AEFIs were less often reimmunized (60% versus 80%; rate ratio: 0.8; 95% confidence interval: 0.66-0.86). Conclusions: Most patients with a history of mild or moderate AEFI can be safely reimmunized. Additional studies are needed in patients with serious AEFIs who are less likely to be reimmunized.

Idioma originalEnglish
Páginas (desde-hasta)377-383
Número de páginas7
PublicaciónPediatric Infectious Disease Journal
Volumen38
N.º4
DOI
EstadoPublished - abr. 1 2019

Nota bibliográfica

Funding Information:
This study was funded by the Ministère de la santé et des Services sociaux du Québec and by l’Institut national de santé publique du Québec. J.G.Z. received a PhD scholarship from the Canadian Immunization Research Net-work (CIRN), which is sponsored by the Public Health Agency of Canada and the Canadian Institutes of Health Research.

Funding Information:
G.D.S. has received investigator initiated grants from GlaxoSmithKline and Pfizer. K.A.T. has received in-kind research support from Pfizer and research grant from GlaxoSmithKline. The other authors have no conflicts of interest to disclose.

Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.

ASJC Scopus Subject Areas

  • Pediatrics, Perinatology, and Child Health
  • Microbiology (medical)
  • Infectious Diseases

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