Current Allergy and Asthma Reports

, Volume 4, Issue 6, pp 447–453 | Cite as

Update on side effects from common vaccines

  • Benjamin J. Song
  • Rohit K. Katial


Vaccines have had a tremendous impact on public health by reducing morbidity and mortality from a variety of virulent pathogens. However, unintended side effects continue to pose a potential risk that may outweigh the vaccine’s protective attributes. In this review, we discuss recent articles and controversies pertaining to vaccineassociated adverse events. Included in the discussion are influenza, hepatitis B, measles-mumps-rubella, diphtheriatetanus-pertussis, polio, Haemophilus influenzae type b, and rotavirus vaccines. The importance and contribution of vaccine constituents (such as thimerosal) to side effects is also reviewed.


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erences and Recommended Reading

  1. 1.
    Ales NC, Katial RK: Vaccines against biologic agents: uses and development. Respir Care Clin North Am 2004, 10:123–146. d review on various formulations of vaccines directed against the category A agents responsible for bioterrorism.CrossRefGoogle Scholar
  2. 2.
    Jacobson RM: Vaccine safety. Immunol Allergy Clin North Am 2003, 23:589–603.PubMedCrossRefGoogle Scholar
  3. 3.
    Zhou W, Pool V, Iskander JK, et al.: Surveillance for safety after immunization: Vaccine Adverse Event Reporting System (VAERS)—United States, 1991–2001. MMWR Morbid Mortal Wkly Rep 2003, 52:1–24. etrospective study of adverse events reported to VAERS during the past decade show that the most common reports were self-limited and localized to the injection site.Google Scholar
  4. 4.
    Tata LJ, West J, Farrington P, et al.: Does influenza vaccination increase consultations, corticosteroid prescriptions, or exacerbations in subjects with asthma or chronic obstructive pulmonary disease? Thorax 2003, 58:835–839.PubMedCrossRefGoogle Scholar
  5. 5.
    Schonberger LB, Bregman DJ, Sullivan-Bolyai JZ, et al.: Guillain-Barre syndrome following vaccination in the National Influenza Immunization Program, United States, 1976–1977. American Journal of Epidemiology 1979, 110:105–123.PubMedGoogle Scholar
  6. 6.
    Geier MR, Geier DA, Zahalsky AC: Influenza vaccination and Guillain Barre Syndrome. Clin Immunol 2003, 107:116–121. following influenza vaccination was shown by review of VAERS; in addition, endotoxin levels were measured and found to vary significantly and potentially partially account for adverse events.PubMedCrossRefGoogle Scholar
  7. 7.
    DeKeyser J, Zwanikken C, Boon M: Effects of influenza vaccination and influenza illness on exacerbations in multiple sclerosis. J Neurol Sci 1998, 159:51–53.CrossRefGoogle Scholar
  8. 8.
    Mutsch M, Zhou W, Rhodes P, et al.: Use of inactivated intranasal influenza vaccine and the risk of Bell’s palsy in Switzerland. N Engl J Med 2004, 350:896–903.PubMedCrossRefGoogle Scholar
  9. 9.
    e SerresG, Boulianne N, Duval B, et al.: Oculo-respiratory syndrome following influenza vaccination: evidence for occurrence with more than one influenza vaccine. Vaccine 2003, 21:2346–2353.PubMedCrossRefGoogle Scholar
  10. 10.
    De Serres G, Grenier JL, Toth E, et al.: The clinical spectrum of the oculo-respiratory syndrome after influenza vaccination. Vaccine 2003, 21:2354–2361.PubMedCrossRefGoogle Scholar
  11. 11.
    Jastaniah WA, Dobson S, Lugsdin JG, Petty RE: Complex regional pain syndrome after hepatitis B vaccine. J Pediatr 2003, 143:802–804.PubMedCrossRefGoogle Scholar
  12. 12.
    Duclos P: Safety of immunization and adverse events following vaccination against hepatitis B. Expert Opin Drug Saf 2003, 2:225–231.PubMedCrossRefGoogle Scholar
  13. 13.
    Black C, Kaye JA, Jick H: MMR vaccine and idiopathic thrombocytopaenic purpura. Br J Clin Pharmacol 2003, 55:107–111.PubMedCrossRefGoogle Scholar
  14. 14.
    Jadavji T, Scheiflele D, Halperin S: Thrombocytopenia after immunization of Canadian children, 1992 to 2001. Pediatr Infect Dis J 2003, 22:119–122.PubMedCrossRefGoogle Scholar
  15. 15.
    Ki M, Park T, Yi SG, et al.: Risk analysis of aseptic meningitis after measles-mumps-rubella vaccination in Korean children by using a case-crossover design. Am J Epidemiol 2003, 157:158–165. ng a cross-over design, the side effects of MMR-related aseptic meningitis were determined to be dependent upon the strain of virus used to produce the vaccine.PubMedCrossRefGoogle Scholar
  16. 16.
    LeSaux N, Barrowman NJ, Moore DL, et al.: Decrease in hospital admissions for febrile seizures and reports of hypotonic-hyporesponsive episodes presenting to hospital emergency departments since switching to acellular pertussis vaccine in Canada: a report from IMPACT. Pediatrics 2003, 112:e348–353. After switching from DTwP to DTaP, rates of seizures and hypotonichyporesponsive episodes declined, whereas rates remained unchanged following MMR vaccination.CrossRefGoogle Scholar
  17. 17.
    Wakefield AJ, Murch SH, Anthony A, et al.: Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children. Lancet 1998, 351:637–641.PubMedCrossRefGoogle Scholar
  18. 18.
    Kaye JA: Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. BMJ 2001, 322:460–463.PubMedCrossRefGoogle Scholar
  19. 19.
    Dales L, Hammer SJ, Smith NJ: Time trends in autism and in MMR immunization coverage in California. J Am Med Assoc 2001, 285:1183–1185.CrossRefGoogle Scholar
  20. 20.
    Madsen KM, Hviid A, Vertergaard M, et al.: MMR vaccination and autism—a population-based follow-up study. Ugeskr Laeger 2003, 164:5741–5744.Google Scholar
  21. 21.
    Taylor B, Miller E, Farrington CP, et al.: Autism and measles, mumps, and rubella vaccine: no epidemiologic evidence for a causal association. Lancet 1999, 353:2026–2029.PubMedCrossRefGoogle Scholar
  22. 22.
    Taylor B, Miller E, Lingam R, et al.: Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. BMJ 2002, 324:393–396.PubMedCrossRefGoogle Scholar
  23. 23.
    Wilson K, Mills E, Ross C, et al.: Association of autistic spectrum disorder and the measles, mumps and rubella vaccine. Arch Pediatr Adolesc Med 2003, 157:628–634. Systematic review of literature does not support an association between MMR and autism, although epidemiologic studies make ruling out a rare variant of ASD difficult. Studies consistently show no increase in MMR vaccination rates to account for the increased autism rates and, furthermore, no temporal correlation of autism with age of MMR administration.PubMedCrossRefGoogle Scholar
  24. 24.
    Fombonne E, Chakrabarti S: No evidence for a new variant of measles-mumps-rubella-induced autism. Pediatrics 2001, 108:e58–64.PubMedCrossRefGoogle Scholar
  25. 25.
    Andrews N, Miller E, Taylor B, et al.: Recall bias, MMR and autism. Arch Dis Child 2002, 87:493–494. Findings of this study demonstrate the phenomenon of recall bias that is likely playing a significant role in the propagation of the purported link between MMR and autism.PubMedCrossRefGoogle Scholar
  26. 26.
    The National Academies: Immunization Safety Review: vaccines and autism. s030909237X? OpenDocument. Accessed June 1, 2004.Google Scholar
  27. 27.
    Halperin SA, Scheifele D, Mills E, et al.: Nature, evolution, and appraisal of adverse events and antibody response associated with the fifth consecutive dose of a five-component acellular pertussis-based combination vaccine. Vaccine 2003, 21:2298–2306.PubMedCrossRefGoogle Scholar
  28. 28.
    Woo EJ, Burwen DR, Gatumu SNM, Ball R: Extensive limb swelling after immunization: reports to the vaccine adverse event reporting system. Clin Infect Dis 2003, 37:351–358.PubMedCrossRefGoogle Scholar
  29. 29.
    Cody CL, Baraff LJ, Cherry JD, et al.: Nature and rates of adverse reactions associated with DTP and DT immunizations in infants and children. Pediatrics 1981, 68:650–659.PubMedGoogle Scholar
  30. 30.
    DuVernoy TS, Braun MM: Hypotonic-hyporesponsive episodes reported to the vaccine adverse event reporting system (VAERS), 1996–1998. Pediatrics 2000, 106:e52-e61.PubMedCrossRefGoogle Scholar
  31. 31.
    Mayorga C, Torres MJ, Corzo JL, et al.: Immediate allergy to tetanus vaccine: determination of immunoglobulin E and immunoglobulin G antibodies to allergenic proteins. Ann Allergy Asthma Immunol 2003, 90:238–243.PubMedCrossRefGoogle Scholar
  32. 32.
    Engels EA, Katki HA, Nielsen NM, et al.: Cancer incidence in Denmark following exposure to poliovirus vaccine contaminated with simian virus 40. J Natl Cancer Inst 2003, 95:532–539.PubMedCrossRefGoogle Scholar
  33. 33.
    Wahlberg J, Fredriksson J, Vaarala O, Ludvigsson J: Vaccinations may induce diabetes-related autoantibodies in one-year-old children. Ann N Y Acad Sci 2003, 1005:404–408.PubMedCrossRefGoogle Scholar
  34. 34.
    Murphy TV, Smith PJ, Gargiullo PM, Schwartz B: The first rotavirus vaccine and intussusception epidemiological studies and policy decisions. J Infect Dis 2003, 187:1309–1313. The discovery of increased intussusception rate following rotavirus vaccination is examined. Although review of the literature suggests a slightly lower than reported rate, the absolute increase was deemed unacceptable.PubMedCrossRefGoogle Scholar
  35. 35.
    Gershon A: Varicella vaccine: rare serious problems—but the benefits still outweigh the risks. J Infect Dis 2003, 188:945–947.PubMedCrossRefGoogle Scholar
  36. 36.
    Offit PA, Jew RK: Addressing parents’ concerns: Do vaccines contain harmful preservatives, adjuvants, additives or residuals? Pediatrics 2003, 112:1394–1401. The concept of vaccine constituents is addressed and includes discussion of preservatives, adjuvants, additives, and residuals/AE.PubMedCrossRefGoogle Scholar
  37. 37.
    Geier MR, Geier DA: Neurodevelopmental disorders after thimerosal-containing vaccines: a brief communication. Exper Biol Med 2003, 228:660–664.Google Scholar
  38. 38.
    Hviid A, Stellfeld M, Wohlfahrt J, Melbye M: Association between thimerosal-containing vaccine and autism. JAMA 2003, 290:1763–1766.PubMedCrossRefGoogle Scholar
  39. 39.
    Stehr-Green P, Tull P, Stellfeld M, et al.: Autism and thimerosalcontaining vaccines: lack of consistent evidence for an association. Am J Prevent Med 2003, 25:101–106. In a study involving three countries, rates of autism increase could not be accounted for by increased exposure to thimerosal.CrossRefGoogle Scholar
  40. 40.
    Grabestein J, Pharm MS: Clinical management of hypersensitivities to vaccine components. Hosp Pharm 1997, 32:77–78.Google Scholar
  41. 41.
    Jefferson T, Rudin M, DiPietrantonj C: Adverse events after immunization with aluminum-containing DTP vaccines: systematic review of evidence. Lancet Infect Dis 2004, 4:84–90.PubMedCrossRefGoogle Scholar
  42. 42.
    Zeiger RS: Current issues with influenza vaccination in egg allergy. J Allergy Clin Immunol 2002, 110:834–840. The interaction between egg allergy and influenza vaccine is reviewed. Even in egg allergic patients, influenza vaccination is safe to administer in a two-dose, graded regimen if the egg content is <1.2 μg/dose.PubMedCrossRefGoogle Scholar

Copyright information

© Current Science Inc 2004

Authors and Affiliations

  • Benjamin J. Song
    • 1
  • Rohit K. Katial
    • 1
  1. 1.Division of Adult Allergy and ImmunologyNational Jewish Medical and Research CenterDenverUSA

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