Adverse events following immunization (AEFI) in patients with Primary Immunodeficiencies.
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1
Universidad de Antioquia, Grupo de Inmunodeficiencias Primarias, Colombia
Introduction. Adverse Events Following Immunization (AEFI) require special consideration in patients with Primary Immunodeficiency Diseases (PID) because they represent in many cases the “red flag” for the initial diagnosis of the disease, determine prognosis and complications and help to define appropriate vaccination schemes according to the type of PID.
Objective. The aim of this study is to describe the epidemiologic pattern of AEFI in a cohort of patients with PID.
Methods. This study included 379 medical records from PID patients. The AEFI severity was classified according to the WHO 1999 guidelines in: common, minor, rare and more serious vaccine reactions. The assessment of causality was performed following the CISA-2009 criteria.
Results. Evidence of AEFI was found in 26 medical records (7% of the PID medical records analyzed, 84% males) and represented a total of 29 reactions. AEFI occurred before or at the same age of the PID diagnosis in most patients. Idiopathic hypogammaglobulinemia (IHG), CGD and SCID were the disorders more susceptible to present with AEFI with 10, 4 and 4 cases, respectively. A total of 24 reactions were associated to replicative vaccines, 7 and 10 with BCG and OPV respectively, and the rest related to MMR, Haemophilus influenzae or varicella vaccination. BCG was the vaccine more often associated to definitive AEFI in PID.
Conclusions. Our findings revealed increased risk of serious AEFI in patients with PID. The overall risk varies depending on the vaccine applied and the underlying condition of the patient. The risk of AEFI increased after the administration of live compared with non-live vaccines. Our study also described the increased risk of seizures in PID patients vaccinated with DPT.
Clinical Implications: Information about the AEFI in vaccines circulating in the immunization schemes of vulnerable population such as PID patients, might represent a tremendous tool to decrease the burden of these diseases and are essential for their timely diagnosis, appropriate management and improve prognosis.
Keywords:
Primary Immunodeficiency Diseases,
Live vaccines,
non-live vaccines,
Adverse events following immunization,
BCG Vaccine
Conference:
IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología, Medellin, Colombia, 13 Oct - 16 Oct, 2015.
Presentation Type:
Poster Presentation
Topic:
Immunodeficiencies
Citation:
Sarmiento Delgado
JD,
Trujillo Vargas
CM,
Villada
FA,
Orrego Arango
JC and
Franco
JL
(2015). Adverse events following immunization (AEFI) in patients with Primary Immunodeficiencies..
Front. Immunol.
Conference Abstract:
IMMUNOCOLOMBIA2015 - 11th Congress of the Latin American Association of Immunology - 10o. Congreso de la Asociación Colombiana de Alergia, Asma e Inmunología.
doi: 10.3389/conf.fimmu.2015.05.00124
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Received:
12 May 2015;
Published Online:
14 Sep 2015.
*
Correspondence:
PhD. Claudia M Trujillo Vargas, Universidad de Antioquia, Grupo de Inmunodeficiencias Primarias, Medellin, Colombia, cmtruji@gmail.com