Rubella 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... 

Adverse effects on the nervous system that have at least temporally been associated with rubella vaccination include myehtis, myeloradiculitis (SEDA-2, 268) (SEDA-20, 292), meningomyelitis (SEDA-10,291), ence-phahtis (SEDA-5, 308), peripheral neuropathy (SEDA-12, 284), facial or peripheral paresthesia (SEDA-11, 295) (SEDA-12, 284), and carpal tunnel syndrome (SEDA-12, 284). In many of these cases the causal relation was doubtful. The authors of the report of the Institute of Medicine, National Academy of Sciences, Washington, DC (1991) entitled Adverse Effects of Pertussis and Rubella Vaccines (38) considered that there was insufficient evidence to indicate either the presence or absence of a causal relation between RA 27/3 rubella vaccine and radiculoneuritis and other neuropathies. 

However, the authors of the report of the Institute of Medicine, National Academy of Sciences, Washington, DC (1991) entitled Adverse Effects of Pertussis and Rubella Vaccines (38) considered that there was insufficient evidence to indicate either the presence or absence of a causal relation between RA 27/3 rubella vaccine and thrombocytopenic purpura. 

Howson CP, Howe CJ, Fineberg HV, editors. Adverse Effects of pertussis and rubella vaccines. A report of the Committee to Review the Adverse Consequences of Pertussis and Rubella Vaccines. Washington, DC National Academy Press, 1991. 

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). 

Howson, C.P. Fineberg, H.V. The ricochet of magic bullets Summary of the Institute of Medicine Report, Adverse Effects of Pertussis and Rubella Vaccines. Pediatrics 1992, Feb., 89 (2), 318-324. 

Adverse effects of the rubella virus vaccine tend to increase with the age of the recipient. Symptoms are similar to wild-virus infection and include lymphadenopathy, rash, urticaria, fever, malaise, sore throat, headache, myalgias, and paresthesias of the extremities. These occur 7 to 12 days after vaccination and last 1 to 5 days. Joint symptoms occur more often in susceptible postpubertal females. Arthralgia occurs in 25% of such vaccinees, and 10% will have arthritislike symptoms. These symptoms usually begin 1 to 3 weeks after vaccination and persist for 1 day to 3 weeks. A very small excess risk of chronic arthropathy exists. The vaccine may cause suppression of tuberculin skin tests for up to 6 weeks after vaccination. While the vaccine virus may be excreted in nose and throat secretions, it is not contagious. 

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. 

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