Summary
Despite a continuous search for safer and more immunogenic vaccines, adverse reactions still occur. Adverse reactions to vaccines are generally mild; severe events resulting in death or permanent damage are rare. In every instance, the benefits of preventing the disease far outweigh the risks of vaccination. In the early days of vaccine development, a number of accidents were associated with faulty production. Most recent problems encountered with the use of vaccines are due to programmatic errors. Because of the large number of doses administered it is probable that there will be some temporal and merely coincidental association between adverse events and vaccine administration. Immunisation has a direct protective effect for the individual and an indirect effect on herd immunity for the community.
The major goal of postmarketing surveillance is the early detection of and appropriate response to adverse events in order to curtail a negative impact on immunisation programmes. Risk-benefit analyses for immunisation are faced with a number of potential difficulties; definition of the risks and benefits themselves, individual versus community risks and benefits, and the continuously evolving nature of risks with changes in disease epidemiology. Based on risk-benefit studies, for an individual just as for the community, it may not always be of interest to use the vaccine with the lowest complication rate. Good immunisation programmes should help to decrease the risk of adverse effects.
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Ambrosch F, Wiedermann G. Changes of risk and benefit in immunisation against pertussis and tuberculosis. Developments in Biological Standardization 43: 85–90, 1979
Bergler R. Impfbarrieren und Impfmotivation. Zentralblatt für Bakteriologie, Mikrobiologie und Hygiene I. Abteilung, Originale 180: 190–222, 1985
Burgess MA. Immunisation: risks vs benefits in the community. Current Therapeutics (Australia) 28: 19–31, 1987
Centers for Disease Control. Pertussis vaccination: acellular pertussis vaccine for reinforcing and booster use — supplementary ACIP statement. Morbidity and Mortality Weekly Report 41/ RR-1: 1–10, 1992
Davies JW. Workshop on scrapie-related disease control. Canada Diseases Weekly Report 17: 89–96, 1991
Dittman S. Immunological preparations. In Dukes MNG (Ed.) Meylers’s side effects of drugs, 11th ed., Elsevier, Amsterdam, 1988
Dudgeon A. Compensation for handicaps as a result of vaccination. Midwife Health Visit Community Nurse 14: 341–346, 1978
Fulginiti VA. Patient education for immunisations. Pediatrics 74(Suppl.): 961–963, 1984
Fulginiti VA. How safe are pertussis and rubella vaccines? A commentary on the Institute of Medicine Report. Pediatrics 89: 334–336, 1992
Furesz J, Contreras G. Vaccine-related mumps meningitis — Canada. Canada Diseases Weekly Report 16: 253–254, 1990
Galazka AM, Lauer BA, Henderson RA, Keja J. Indications and contraindications for vaccines used in the expanded programme on immunisation. World Health Organization Bulletin 62: 357, 1984
Holden JD. Benefits and risks of childhood immunisations in developing countries. British Medical Journal 294: 1329–1331, 1987
Howson CP, Howe CJ, Fineberg HV. Adverse effects of pertussis and rubella vaccine, National Academy Press, Washington, 1991
Koplan JP. Benefits, risks and costs of immunisation programmes. Ciba Foundation Symposium 110: 55–68, 1985
Koplan JP, Schoenbaum SC, Weinstein MC, Fraser DW. Pertussis vaccine — an analysis of benefits, risks and costs. New England Journal of Medicine 301: 906–911, 1979
Lotte A, Wasz-Hockert O, Poisson N. Second IUATLD study on complications induced by intradermal BCG-vaccination. Bulletin of the International Union Against Tuberculosis and Lung Disease 63: 47–59, 1988
Mariner WF, Clark ME. Confronting the immunisation problem: proposals for compensation reform. American Journal of Public Health 76: 703–708, 1986
Miller D, Wadsworth J, Diamond J, Ross E. Pertussis vaccine and whooping cough as risk factors in acute neurological illness and death in young children. Developments in Biological Standardization 61: 389–394, 1985
Nicholson RH (Ed.). Medical research with children: ethics, law, and practice, Oxford University Press, Oxford, 1986
Nokes DJ, Anderson RM. Vaccine safety versus vaccine efficacy in mass immunisation programmes. Lancet 338: 1309–1312, 1991
Plotkin SL, Plotkin SA. Vaccines, pp. 1–7, W.B. Saunders Company, Philadelphia, 1988
Report of the Committee on Infectious Diseases, 22nd ed., American Academy of Pediatrics, Elk Grove Village, 1991
Royce F. The vaccine debate: kids at risk? American Health: Fitness of Body and Mind 9: 49, 1990
Strebel PM, Sutter RW, Cochi SL, Bielik RJ, Brink EW, et al. Epidemiology of poliomyelitis in the United States one decade after the last reported case of indigenous wild virus-associated disease. Clinical Infectious Diseases 14: 568–579, 1992
Stuart-Harris C. Benefits and risks of immunisation against pertussis. Development in Biological Standardization 43: 75–83, 1979
Sugiura A, Yamada A. Aseptic meningitis as a complication of mumps vaccination. Pediatric Infectious Disease Journal 10 209–213, 1991
Takala AK, Eskola J, Leinonen M, Käyhty H, Nissinen A, et al. Reducation of oropharyngeal carriage of Haemophilus influenzae type b (Hib) in children immunised with Hib conjugate vaccine. Journal of Infectious Diseases 164: 982–986, 1991
Velimirovic B. Social, economic and psychological impacts of childhood diseases subject to immunisation. Infection 19: 237–241, 1991
Wassilak SGF, Sokhey J. Monitoring of adverse events following immunisation in the expanded programme on immunisation, WHO/EPI/GEN/91.2., World Health Organization, Geneva, 1990
Wiedermann G, Ambrosch F, Kollaritsch H, Kundi M. Risks and benefits of vaccinations. Infection Control 5: 438–444, 1984
Wilson GS. The hazards of immunisation, Athlone Press, London, 1967
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Duclos, P., Bentsi-Enchill, A. Current Thoughts on the Risks and Benefits of Immunisation. Drug-Safety 8, 404–413 (1993). https://doi.org/10.2165/00002018-199308060-00002
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DOI: https://doi.org/10.2165/00002018-199308060-00002