Measles vaccine adverse effects

AZATHIOPRINE VACCINES i effectiveness of vaccines, t risk of adverse/toxic effects of live vaccines (e.g. measles, mumps, rubella, oral polio, BCG, yellow fever, varicella, TY21a typhoid), e.g. vaccinal infections Disseminated infection due to enhanced replication of vaccine virus in the presence of diminished immunocompetence Do not vaccinate when patients are on immunosuppressants. Vaccination should be deferred for at least 3 months after discontinuing immunosuppressants/myelosuppres-sants. If an individual has been recently vaccinated, do not initiate therapy for at least 2 weeks after vaccination... 

However, if large amounts are applied, particularly under occlusion, it can be sufficiently well absorbed to cause systemic effects. Three of 1648 children who received measles vaccination with Emla 1 g had adverse reactions 10-20 minutes later all required adrenaline for similar symptoms of weakness and dizziness with a cold clammy skin and no pulse or a weak pulse (2). One went on to wheeze markedly and had peripheral cyanosis and shivering, improving with hydrocortisone. The authors proposed that these unusual reactions could have been due to a biphasic local reaction to Emla, with vasodilatation leading to increased absorption and further toxicity. 

The risks of adverse effects after immnnization against diphtheria, pertussis, tetanus, pohomyehtis, measles, and tuberculosis have been discussed in the framework of the WHO Expanded Program on Immunization and compared with the complication rate following natural disease (40). Table 8 presents a comparison of the estimated risks of adverse reactions after DTP immunization with the complication rates of natural whooping cough, while Table 9 shows a similar comparison for measles immunization and natural measles. The authors concluded that no vaccine is without adverse effects, but that the risks of serious complications from vaccines used in WHO s Expanded Program on Immunization are much lower than the risks from the natural disease. 

The reports of the Institute of Medicine, National Academy of Sciences, Washington (on adverse events after pertussis and mbeUa immnnization (SED-12, 817) (SED-12, 825) and on adverse events after immunization against tetanus, diphtheria, measles, mumps, poliomyelitis, H. influenzae type b, and hepatitis B (SEDA-18,325) have provided useful reviews (13,14). The 1996 Update on vaccine side effects, adverse reactions, contraindications,... 

Various studies in both symptomatic and asymptomatic HIV-infected individuals have failed to show any special sensitivity to adverse effects after other immunizations, for example in children receiving live oral or inactivated polio vaccine, DPT or DT vaccine, or measles vaccine (98-101). 

The measles vaccine has an excellent safety record. The most common side effect following vaccination is fever, which occurs in 5% to 15% of vaccinees. Transient generalized rash may occur in about 5% of vaccine recipients. These reactions generally appear 5 to 12 days postvaccination and last 2 to 5 days. Other adverse effects, such as headache, cough, sore throat, eye pain, malaise, and transient thrombocytopenia, occur less frequently. Local reactions at the injection site, while rare, may occur in subjects who have been vaccinated previously with killed vaccine. No association between MMR vaccination and the development of autism has been made following extensive study. Febrile seizures occur rarely, and there is no association between MMR vaccination and the development of a subsequent seizure disorder. ... 

A critical examination (4) of a report (5) of several children whose chronic bowel and behavioral abnormalities were linked to measles, mumps, and rubella (MMR) immunization can be used as an example to underline Halsey s comments. Without effective and credible systems for the detection of vaccine-associated adverse events through pharmacovigilance, for distinguishing causal reactions from coincidental reactions by pharmacoepidemiological or other studies, and for risk communication, vaccine safety concerns may confuse the media and the public. 

In the USA, the National Childhood Vaccine Injury Act of 1986 established the National Vaccine Injury Compensation Program as a federal no-fault compensation system for individuals who may have been injured by specific vaccines. This compensation program relies on a Vaccine Injury Table that lists the vaccines that are covered by the program, as well as injuries, disabilities, illnesses, and conditions (including death) for which compensation may be awarded. To better reflect current scientific knowledge about vaccine injuries, the Vaccine Injury Table was revised in 1995 and has been subsequently further modified. The latest modification, which became effective on December 1, 2004, is shown in Table 7. This revision took into account a review of the literature on specific adverse consequences of pertussis and rubella vaccines performed and published by the lOM (SED-12, 817) (SED-12, 825). In addition to the seven vaccines (diphtheria, pertussis, tetanus, measles, mumps, rubella, and poliomyelitis) included in the first Vaccine Injury Table, the 1997 revision includes hepatitis B, Hemophilus influenzae type b, and Varicella vaccines, as well as any future licensed vaccine recommended by the Advisory Committee on Immunization Practices (ACIP) for routine administration to children (38). 

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