Sen S, Cloete Y, Hassan K, Buss P. Adverse events following vaccination in premature infants.
Acta Paediatr 2001 Aug;90(8):916-920  Department of Paediatrics and Neonatology, Royal Gwent Hospital, Newport, UK.
The aims of this study were to study the frequency, severity and types of adverse reactions following DPT/Hib (diphtheria and tetanus toxoids and pertussis/Haemophilus influenzae type B conjugate) immunization in very preterm infants and to identify possible risk factors. Case notes of 45 preterm babies vaccinated in the neonatal intensive care unit between January 1993 and December 1998 were studied retrospectively. Birthweight, gestational age, duration of ventilation, oxygen dependency, timing of vaccination, weight, corrected gestation at vaccination and apparent adverse effects were noted. Apparent adverse events were noted in 17 of 45 (37.8%) babies: 9 (20%) had major events, i.e. apnoea, bradycardia or desaturations, and 8 (17.8%) had minor events, i.e. increased oxygen requirements, temperature instability, poor handling and feed intolerance. Babies with major events were significantly younger (p < 0.05), had a lower postmenstrual age (p < 0.05) and weighed less (p < 0.05) at the time of vaccination compared with babies without major events. No differences in the mean birthweight, gestational age, duration of ventilation or oxygen dependency were found between the two groups. Age at vaccination of 70 days or less was significantly associated with increased risk (p < 0.01). Of 27 babies vaccinated at 70 days or less, 9 (33.3%) developed major events compared with none when vaccinated over 70 d. CONCLUSION: Vaccine-related cardiorespiratory events are relatively common in preterm babies. Problems were much more common if vaccine is administered at or before 70 d. These babies should therefore be monitored postvaccination. Further prospective studies are needed to clarify whether delaying vaccination offers protection against these adverse events. PMID: 11529542 [PubMed - in process]

Jovanovic D.     Respiratory effects of live influenza virus vaccine. Am Rev Respir Dis. 1977 Dec;116(6):1121. No abstract available.PMID: 931188; UI: 78058888     

Nicholson, Karl G.; Nguyen-Van-Tam, Jonathan S.; Ahmed, Ala'eldin H.; et al. "Randomized Placebo-Controlled Crossover Trial on Effect of Inactivated Influenza Vaccine on Pulmonary Function in Asthma" Lancet (01/31/98) Vol. 351, No. 9099, P. 326;

British researchers report that there is a correlation between pulmonary-function abnormalities and complications due to flu vaccination, although the risk is quite small and the benefits of vaccination outweigh the complications that may occur. The team studied 262 adults in a double-blind, placebo-controlled crossover study of 262 adults to evaluate the safety of flu vaccination in asthma patients. Despite current guidelines, asthma patients often do not receive annual flu shots, in part, due to concerns that the vaccine will trigger exacerbations. For two weeks before the first injection until two weeks after the second injection, the subjects kept a record of daily peak expiratory flow (PEF), respiratory symptoms, medication, medical consultations, and hospital admissions. Of the 255 patients with paired data, 11 saw a reduction in PEF greater than 20 percent, while eight had a decline in PEF of more 30 percent. Only three of the placebo receiving subjects had PEF reduction greater than 20 percent, and none had a reduction greater than 30 percent. When the researchers excluded subjects with colds--which can trigger exacerbations and may be mistaken for vaccine-related adverse events--there was no significant difference in PEF decline, although they said the difference for PEF declines of more than 30 percent approached significance.

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