Resumen
CONTEXT: Reimmunizing patients who had an adverse event following immunization (AEFI) is sometimes a challenge because there are limited data on the risk and severity of AEFI recurrence. OBJECTIVE: To summarize the literature on the risk of AEFI recurrence. DATA SOURCES: PubMed, Embase, and Cochrane library. STUDY SELECTION: We included articles in English or French published before September 30, 2016. Articles were selected if they estimated the risk of AEFI recurrence in at least 5 individuals. Studies with experimental vaccines were excluded. DATA EXTRACTION: Data on study design, setting, population, vaccines, and AEFI recurrence were extracted. RESULTS: Twenty-nine articles were included. Among patients with a history of hypotonic hyporesponsive episode (n = 398), anaphylaxis (n = 133), or seizures (n = 60) who were reimmunized, events recurred in 0% to 0.8%. Allergic-like events recurred in 30 of 594 reimmunized patients. Fever recurred in 0% to 84% of 836 reimmunized patients, depending on the vaccine and dose number. Among children with extensive limb swelling after the fourth dose of diphtheria-tetanus-acellular pertussis vaccine, recurrence was higher when the fifth dose was given withthe full-antigen formulation (78%) compared with the reduced-antigen formulation (53%, P = .02) LIMITATIONS: Many studies, included few patients, and those with severe AEFIs were often not reimmunized. CONCLUSIONS: Despite vaccines being administered to millions of people annually, there are few studies in which researchers evaluated AEFI recurrence. Published studies suggest that reimmunization is usually safe. However in these studies, severe cases were often not reimmunized.
Idioma original | English |
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Número de artículo | e20163707 |
Publicación | Pediatrics |
Volumen | 140 |
N.º | 3 |
DOI | |
Estado | Published - sep. 2017 |
Nota bibliográfica
Funding Information:PoTenTIAL conFLIcT oF InTeResT: Dr De Serres has received investigator-initiated grants from GlaxoSmithKline and Pfizer and travel reimbursement to attend an ad hoc advisory board meeting of GlaxoSmithKline; Dr Top has received in-kind research support from Pfizer and a grant from GlaxoSmithKline; and the other authors have indicated they have no potential conflicts of interest to disclose.
Funding Information:
FUndInG: This study was funded by the Canadian Immunization Research Network, which is sponsored by the Public Health Agency of Canada and the Canadian Institutes of Health Research.
Publisher Copyright:
© 2017 by the American Academy of Pediatrics.
ASJC Scopus Subject Areas
- Pediatrics, Perinatology, and Child Health