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Published in: Italian Journal of Pediatrics 1/2014

Open Access 01-12-2014 | Research

Vaccine risk assessment in children with a referred reaction to a previous vaccine dose: 2009–2011 retrospective report at the Bambino Gesu’ children hospital, Rome, Italy

Authors: Luciana Nicolosi, Annachiara Vittucci, Rossella Mancini, Elena Bozzola, Alberto Cagigi, Annalisa Grandin, Alberto Villani

Published in: Italian Journal of Pediatrics | Issue 1/2014

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Abstract

Background

During the last century, mass vaccination programs have achieved considerable success across the world in immunizing against several serious infectious diseases. However, vaccinations are threatened by their own success after results have been obtained: the more the incidence of potentially devastating diseases decreases, thanks to the success of vaccination programs, the more public attention shifts towards real or alleged “side effects” of vaccines.

Methods

We analyze the experience of 153 children with “reaction to a previous vaccine dose” continuing the vaccination protocol in the safe environment of the Center for risk vaccination at the Bambino Gesù Children’s Hospital IRCCS in Rome, from 2009 to 2011.

Results

To assess the suitability for vaccination, a specialized pre-vaccination advice and a skin prick test (SPT) was undergone, according to Wood’s guideline; 151 children were SPT negative and full vaccine was administered. Of the 153 children examined just 13 had symptoms suggestive of IgE-mediated reaction-type reactions with angioedema manifestations. Among them, 2 had positive STP, which required alternative measures of administration of the vaccine. No cases of post vaccination reaction was reported and no vaccination program was stopped due to a severe reaction.

Conclusions

Inadequate levels of immunization against infectious diseases remain a significant problem for public health. However, the reasons for incomplete vaccination and non-adoption of vaccination services are manifold. To maintain public confidence in vaccines, advanced immunization programs must include activities for monitoring the safety of the vaccine at the individual level and pursuing specialized counseling pre-and post-vaccination for those at risk. Our results underlined a gap between true and referred adverse reactions and are consistent with vaccine safety. Anyway, a continuous assessment of the risks and benefits of vaccination is required and the results must be disclosed in order to strengthen confidence in the existing and in the new immunization programs.
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Literature
1.
go back to reference Elena B, Mauro B, Valeria C, Salvatore B, Alberto V: “Infectious diseases and vaccination strategies: How to protect the “unprotectable”?. ISRN Prev Med. 2013, 2013 (765354): 5- Elena B, Mauro B, Valeria C, Salvatore B, Alberto V: “Infectious diseases and vaccination strategies: How to protect the “unprotectable”?. ISRN Prev Med. 2013, 2013 (765354): 5-
2.
go back to reference Bozzola E, Bozzola M, Tozzi AE, Nicolosi L, Vittucci A, Villani A: Impact of health care providers’ advice on vaccine refusal for children with an acute nervous system infection. Eur J Pediatr. 2014, Correspondence Published online: 2014 Feb 6 Bozzola E, Bozzola M, Tozzi AE, Nicolosi L, Vittucci A, Villani A: Impact of health care providers’ advice on vaccine refusal for children with an acute nervous system infection. Eur J Pediatr. 2014, Correspondence Published online: 2014 Feb 6
4.
go back to reference Heininger U: The success of immunization-shovelling its own grave?. Vaccine. 2004, 22: 2071-2. 10.1016/j.vaccine.2004.01.018.CrossRefPubMed Heininger U: The success of immunization-shovelling its own grave?. Vaccine. 2004, 22: 2071-2. 10.1016/j.vaccine.2004.01.018.CrossRefPubMed
5.
go back to reference Guillaume L, Bath PA: A content analysis of mass media sources in relation to the MMR vaccine scare. Health Inform J. 2008, 14: 323-34. 10.1177/1460458208096654.CrossRef Guillaume L, Bath PA: A content analysis of mass media sources in relation to the MMR vaccine scare. Health Inform J. 2008, 14: 323-34. 10.1177/1460458208096654.CrossRef
6.
go back to reference American Academy of Pediatrics: Active immunization. Red Book 2006 Report of the Committee on Infectious Diseases. Edited by: Pickering LK, Baker CJ, Long SS, McMillan JA. 2006, Elk Grove Village, IL: American Academy of Pediatrics, 446-448. 27 American Academy of Pediatrics: Active immunization. Red Book 2006 Report of the Committee on Infectious Diseases. Edited by: Pickering LK, Baker CJ, Long SS, McMillan JA. 2006, Elk Grove Village, IL: American Academy of Pediatrics, 446-448. 27
7.
go back to reference Ruggeberg JU, Gold MS, Bayas J-M, Blum MD, Bonhoeffer J, Friedlander S, de Souza BG, Heininger U, Imoukhuede B, Khamesipour A, Erlewyn-Lajeunesse M, Martin S, Mäkelä M, Nell P, Pool V, Simpson N: Brighton collaboration anaphylaxis working group. Anaphylaxis: case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2007, 25 (31): 5675-5684. 10.1016/j.vaccine.2007.02.064.CrossRefPubMed Ruggeberg JU, Gold MS, Bayas J-M, Blum MD, Bonhoeffer J, Friedlander S, de Souza BG, Heininger U, Imoukhuede B, Khamesipour A, Erlewyn-Lajeunesse M, Martin S, Mäkelä M, Nell P, Pool V, Simpson N: Brighton collaboration anaphylaxis working group. Anaphylaxis: case definition and guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine. 2007, 25 (31): 5675-5684. 10.1016/j.vaccine.2007.02.064.CrossRefPubMed
8.
go back to reference Askenase P: Delayed-type hypersensitivity and cellular immunity. Allergy principles and practice. Edited by: Adkinson NF, Yunginger JY, Busse W, Bochner B, Holgate ST, Simons FE. 2003, St Louis, MO: Mosby, 425-452. 6 Askenase P: Delayed-type hypersensitivity and cellular immunity. Allergy principles and practice. Edited by: Adkinson NF, Yunginger JY, Busse W, Bochner B, Holgate ST, Simons FE. 2003, St Louis, MO: Mosby, 425-452. 6
9.
go back to reference Wood RA, Berger M, Dreskin SC, Setse R, Engler RJ, Dekker CL, Halsey NA: Hypersensitivity working group of the clinical immunization safety assessment (CISA) network. An algorithm for treatment of patients with hypersensitivity reactions after vaccines. Pediatrics. 2008, 122 (3): e771-7. 10.1542/peds.2008-1002. doi:10.1542/peds.2008-1002CrossRefPubMed Wood RA, Berger M, Dreskin SC, Setse R, Engler RJ, Dekker CL, Halsey NA: Hypersensitivity working group of the clinical immunization safety assessment (CISA) network. An algorithm for treatment of patients with hypersensitivity reactions after vaccines. Pediatrics. 2008, 122 (3): e771-7. 10.1542/peds.2008-1002. doi:10.1542/peds.2008-1002CrossRefPubMed
10.
go back to reference Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TA, Ring J, Thien F, Van Cauwenberge P, Williams HC: Revised nomenclature for allergy for global use: report of the nomenclature review committee of the world allergy organization, October 2003. J Allergy Clin Immunol. 2004, 113 (5): 832-10.1016/j.jaci.2003.12.591.CrossRefPubMed Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ, Lockey RF, Motala C, Ortega Martell JA, Platts-Mills TA, Ring J, Thien F, Van Cauwenberge P, Williams HC: Revised nomenclature for allergy for global use: report of the nomenclature review committee of the world allergy organization, October 2003. J Allergy Clin Immunol. 2004, 113 (5): 832-10.1016/j.jaci.2003.12.591.CrossRefPubMed
11.
go back to reference Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A, Brown SG, Camargo CA, Cydulka R, Galli SJ, Gidudu J, Gruchalla RS, Harlor AD, Hepner DL, Lewis LM, Lieberman PL, Metcalfe DD, O'Connor R, Muraro A, Rudman A, Schmitt C, Scherrer D, Simons FE, Thomas S, Wood JP, Decker WW: Second symposium on the definition and management of anaphylaxis: summary report–second national institute of allergy and infectious disease/food allergy and anaphylaxis network symposium. J Allergy Clin Immunol. 2006, 117 (2): 391-10.1016/j.jaci.2005.12.1303.CrossRefPubMed Sampson HA, Muñoz-Furlong A, Campbell RL, Adkinson NF, Bock SA, Branum A, Brown SG, Camargo CA, Cydulka R, Galli SJ, Gidudu J, Gruchalla RS, Harlor AD, Hepner DL, Lewis LM, Lieberman PL, Metcalfe DD, O'Connor R, Muraro A, Rudman A, Schmitt C, Scherrer D, Simons FE, Thomas S, Wood JP, Decker WW: Second symposium on the definition and management of anaphylaxis: summary report–second national institute of allergy and infectious disease/food allergy and anaphylaxis network symposium. J Allergy Clin Immunol. 2006, 117 (2): 391-10.1016/j.jaci.2005.12.1303.CrossRefPubMed
12.
go back to reference Mullooly JP, Thompson RS, Bohlke K, Davis RL, Marcy SM, Braun MM, De Stefano F, Black SB, Vaccine Safety Datalink Team: Risk of anaphylaxis after vaccination of children and adolescents. Pediatrics. 2003, 112 (4): 815-10.1542/peds.112.4.815.CrossRefPubMed Mullooly JP, Thompson RS, Bohlke K, Davis RL, Marcy SM, Braun MM, De Stefano F, Black SB, Vaccine Safety Datalink Team: Risk of anaphylaxis after vaccination of children and adolescents. Pediatrics. 2003, 112 (4): 815-10.1542/peds.112.4.815.CrossRefPubMed
13.
go back to reference Advisory Committee on Immunization Practices (ACIP): General recommendations on immunization. National center for immunization and respiratory diseases. MMWR Recomm Rep. 2011, 60 (2): 1- Advisory Committee on Immunization Practices (ACIP): General recommendations on immunization. National center for immunization and respiratory diseases. MMWR Recomm Rep. 2011, 60 (2): 1-
14.
go back to reference Apisarnthanarak A, Uyeki TM, Miller ER, Mundy LM: Serum sickness-like reaction associated with inactivated influenza vaccination among Thai health care personnel: risk factors and outcomes. Clin Infect Dis. 2009, 49 (1): e18-22. 10.1086/599615.CrossRefPubMed Apisarnthanarak A, Uyeki TM, Miller ER, Mundy LM: Serum sickness-like reaction associated with inactivated influenza vaccination among Thai health care personnel: risk factors and outcomes. Clin Infect Dis. 2009, 49 (1): e18-22. 10.1086/599615.CrossRefPubMed
15.
go back to reference Lieberman PL, et al: Anaphylaxis and anaphylactoid reactions. Middleton's allergy principles and practice. Edited by: Adkinson NFJr, Busse WW, Yunginger JW. 2003, St. Louis: Elsevier, 1497-6 Lieberman PL, et al: Anaphylaxis and anaphylactoid reactions. Middleton's allergy principles and practice. Edited by: Adkinson NFJr, Busse WW, Yunginger JW. 2003, St. Louis: Elsevier, 1497-6
16.
go back to reference Bines J: Intussusception and rotavirus vaccines. Vaccine. 2006, 24: 3772-6. 10.1016/j.vaccine.2005.07.031.CrossRefPubMed Bines J: Intussusception and rotavirus vaccines. Vaccine. 2006, 24: 3772-6. 10.1016/j.vaccine.2005.07.031.CrossRefPubMed
17.
go back to reference Kelso JM, Greenhawt MJ, Li JT, Nicklas RA, Bernstein DI, Blessing-Moore J, Cox L, Khan D, Lang DM, Oppenheimer J, Portnoy JM, Randolph CR, Schuller DE, Spector SL, Tilles SA, Wallace D: Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol. 2012, 130 (1): 25-43. 10.1016/j.jaci.2012.04.003.CrossRefPubMed Kelso JM, Greenhawt MJ, Li JT, Nicklas RA, Bernstein DI, Blessing-Moore J, Cox L, Khan D, Lang DM, Oppenheimer J, Portnoy JM, Randolph CR, Schuller DE, Spector SL, Tilles SA, Wallace D: Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol. 2012, 130 (1): 25-43. 10.1016/j.jaci.2012.04.003.CrossRefPubMed
18.
go back to reference Anderson RM: The concept of herd immunity and the design of communitybased immunization programmes. Vaccine. 1992, 10: 928-35. 10.1016/0264-410X(92)90327-G.CrossRefPubMed Anderson RM: The concept of herd immunity and the design of communitybased immunization programmes. Vaccine. 1992, 10: 928-35. 10.1016/0264-410X(92)90327-G.CrossRefPubMed
19.
go back to reference Gallo G, Mel R, Rota MC: Guida alle controindicazioni alle vaccinazioni. Rapporti ISTISAN 09/13. Gallo G, Mel R, Rota MC: Guida alle controindicazioni alle vaccinazioni. Rapporti ISTISAN 09/13.
20.
go back to reference La Russa PS, Edwards KM, Dekker CL, Klein NP, Halsey NA, Marchant C, Baxter R, Engler RJ, Kissner J, Slade BA: Understanding the role of human variation in vaccine adverse events: the Clinical Immunization Safety Assessment network. Pediatrics. 2011, 127 (Suppl 1): S65-73.CrossRef La Russa PS, Edwards KM, Dekker CL, Klein NP, Halsey NA, Marchant C, Baxter R, Engler RJ, Kissner J, Slade BA: Understanding the role of human variation in vaccine adverse events: the Clinical Immunization Safety Assessment network. Pediatrics. 2011, 127 (Suppl 1): S65-73.CrossRef
21.
go back to reference Zanoni G, Berra P, Lucchi I, Ferro A, O'Flanagan D, Levy-Bruhl D, Salmaso S, Tridente G: Vaccine adverse event monitoring systems across the European Union countries: time for unifying efforts. Vaccine. 2009, 27: 3376-84. 10.1016/j.vaccine.2009.01.059.CrossRefPubMed Zanoni G, Berra P, Lucchi I, Ferro A, O'Flanagan D, Levy-Bruhl D, Salmaso S, Tridente G: Vaccine adverse event monitoring systems across the European Union countries: time for unifying efforts. Vaccine. 2009, 27: 3376-84. 10.1016/j.vaccine.2009.01.059.CrossRefPubMed
Metadata
Title
Vaccine risk assessment in children with a referred reaction to a previous vaccine dose: 2009–2011 retrospective report at the Bambino Gesu’ children hospital, Rome, Italy
Authors
Luciana Nicolosi
Annachiara Vittucci
Rossella Mancini
Elena Bozzola
Alberto Cagigi
Annalisa Grandin
Alberto Villani
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2014
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/1824-7288-40-31

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