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Deschanvres C, Levieux K, Launay E, Huby AC, Scherdel P, de Visme S, Hanf M, Gras-Le Guen C. Non-immunization associated with increased risk of sudden unexpected death in infancy: A national case-control study. Vaccine 2023; 41:391-396. [PMID: 36460531 DOI: 10.1016/j.vaccine.2022.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 10/28/2022] [Accepted: 10/31/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In the context of vaccine scepticism, our study aimed to analyse the association between immunization status and the occurrence of sudden unexpected death in infancy (SUDI). STUDY DESIGN A multi-centre case-control study was conducted between May 2015 and June 2017 with data from the French national SUDI registry (OMIN) for 35 French regional SUDI centres. Cases were infants under age 1 year who died from SUDI and who were registered in OMIN. Controls, matched to cases by age and sex at a 2:1 ratio, were infants admitted to Nantes University Hospital. All immunization data for diphtheria (D), tetanus (T), acellular pertussis (aP), inactivated poliovirus (IPV), Haemophilus influenzae b (Hib), hepatitis B (HB) and 13-valent pneumococcal conjugate vaccine (PCV13) were collected by a physician. Cases and controls were considered immunized if at least one dose of vaccine was administered. RESULTS A total of 91 cases and 182 controls were included. The median age was 131 days (interquartile range 98-200.0) and the sex ratio (M/F) was about 1.1. For all vaccines combined (D-T-aP-IPV-Hib and PCV13), 22 % of SUDI cases versus 12 % of controls were non-immunized, which was significantly associated with SUDI after adjustment for potential adjustment factors (adjusted odds ratio 2.01 [95 % confidence interval 1.01-3.98, p = 0,047]). CONCLUSIONS Non-immunization for D-T-aP-IPV-Hib-HB and PCV13 was associated with increased risk of SUDI. This result can be used to inform the general public and health professionals about this risk of SUDI in case of vaccine hesitancy.
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Affiliation(s)
- Colin Deschanvres
- Infectious Diseases Department, Nantes University Hospital, Nantes, France.
| | - Karine Levieux
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France
| | - Elise Launay
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France; Clinical Investigation Centre (CIC004), Inserm CIC 1413, Nantes University Hospital, Nantes, France
| | - Anne-Cécile Huby
- Clinical Investigation Centre (CIC004), Inserm CIC 1413, Nantes University Hospital, Nantes, France
| | - Pauline Scherdel
- Clinical Investigation Centre (CIC004), Inserm CIC 1413, Nantes University Hospital, Nantes, France
| | - Sophie de Visme
- Clinical Investigation Centre (CIC004), Inserm CIC 1413, Nantes University Hospital, Nantes, France
| | - Matthieu Hanf
- Inserm UMR 1181 B2PHI, Versailles Saint Quentin University, Villejuif, France
| | - Christèle Gras-Le Guen
- Pediatric and Emergency Department, University Hospital of Nantes, Nantes, France; Clinical Investigation Centre (CIC004), Inserm CIC 1413, Nantes University Hospital, Nantes, France
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Nie X, Xu L, Bai Y, Liu Z, Liu Z, Farrington P, Zhan S. Self-controlled case series design in vaccine safety: a systematic review. Expert Rev Vaccines 2021; 21:313-324. [PMID: 34937500 DOI: 10.1080/14760584.2022.2020108] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND : An increasing number of vaccine safety studies using the self-controlled case-series (SCCS) design have been conducted in the last decade. However, there has been no comprehensive evaluation of the methodology and reporting quality of these observational studies. The purpose of this paper is to document the methodological features of studies that focused on vaccine safety using the SCCS design, and to evaluate the reporting quality of these studies to suggest future improvements on appropriate design and transparent reporting. METHODS : Databases including Medline, Embase, Web of Science, Scopus and Chinese databases were searched from inception to May 31, 2021. All observational studies regarding vaccine safety using a SCCS design were selected. Information regarding methodological elements were extracted. In addition, reporting quality was assessed using the REporting of studies Conducted using Observational Routinely collected health Data statement for PharmacoEpidemiology (RECORD-PE). RESULTS : Of the 105 studies identified, administrative databases were the main data source for vaccination records and adverse events following immunization (AEFI). 28 articles (27%) used multiple designs to verify the association, and the results obtained with the SCCS design were robust. The top three AEFI studied were intussusception, Guillain-Barré syndrome, and convulsions. Only 21 studies (20%) reported the approach for case validation by chart review. The healthy vaccinee effect was considered by 51studies (49%), with 16 of them (31%) using extended SCCS models to alleviate this effect. Overall, the reporting quality of included studies could be improved. CONCLUSIONS : This study systematically reviewed the methodology of studies regarding vaccine safety using a SCCS design and critically assessed their respective reporting quality. Case validation, the validity of assumptions for standard SCCS, and quality of reporting should be given more importance in future research projects.
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Affiliation(s)
- Xiaolu Nie
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.,Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Lu Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Yi Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zuoxiang Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhike Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Paddy Farrington
- School of Mathematics and Statistics, The Open University, Milton Keynes MK7 6AA, UK
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China.,Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, 100191, China.,Center for Intelligent Public Health, Institute for Artificial Intelligence, Peking University, Beijing, China
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Duszynski KM, Stark JH, Cohet C, Huang WT, Shin JY, Lai ECC, Man KKC, Choi NK, Khromava A, Kimura T, Huang K, Watcharathanakij S, Kochhar S, Chen RT, Pratt NL. Suitability of databases in the Asia-Pacific for collaborative monitoring of vaccine safety. Pharmacoepidemiol Drug Saf 2021; 30:843-857. [PMID: 33634545 DOI: 10.1002/pds.5214] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 02/22/2021] [Indexed: 11/12/2022]
Abstract
INTRODUCTION Information regarding availability of electronic healthcare databases in the Asia-Pacific region is critical for planning vaccine safety assessments particularly, as COVID-19 vaccines are introduced. This study aimed to identify data sources in the region, potentially suitable for vaccine safety surveillance. This manuscript is endorsed by the International Society for Pharmacoepidemiology (ISPE). METHODS Nineteen countries targeted for database reporting were identified using published country lists and review articles. Surveillance capacity was assessed using two surveys: a 9-item introductory survey and a 51-item full survey. Survey questions related to database characteristics, covariate and health outcome variables, vaccine exposure characteristics, access and governance, and dataset linkage capability. Other questions collated research/regulatory applications of the data and local publications detailing database use for research. RESULTS Eleven databases containing vaccine-specific information were identified across 8 countries. Databases were largely national in coverage (8/11, 73%), encompassed all ages (9/11, 82%) with population size from 1.4 to 52 million persons. Vaccine exposure information varied particularly for standardized vaccine codes (5/11, 46%), brand (7/11, 64%) and manufacturer (5/11, 46%). Outcome data were integrated with vaccine data in 6 (55%) databases and available via linkage in 5 (46%) databases. Data approval processes varied, impacting on timeliness of data access. CONCLUSIONS Variation in vaccine data availability, complexities in data access including, governance and data release approval procedures, together with requirement for data linkage for outcome information, all contribute to the challenges in building a distributed network for vaccine safety assessment in the Asia-Pacific and globally. Common data models (CDMs) may help expedite vaccine safety research across the region.
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Affiliation(s)
- Katherine M Duszynski
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - James H Stark
- Vaccine Medical, Scientific and Clinical Affairs, Pfizer Inc., New York, New York, USA
| | - Catherine Cohet
- Vaccines Clinical Research & Development, GlaxoSmithKline, Wavre, Belgium
| | - Wan-Ting Huang
- Office of Preventive Medicine, Taiwan Centers for Disease Control, Taipei, Taiwan
| | - Ju-Young Shin
- School of Pharmacy, Sungkyunkwan University, Suwon, South Korea
| | - Edward Chia-Cheng Lai
- School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Kenneth K C Man
- Research Department of Practice and Policy, UCL School of Pharmacy, London, UK.,Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Nam-Kyong Choi
- Department of Health Convergence, Ewha Womans University, Seoul, South Korea
| | - Alena Khromava
- Epidemiology and Benefit Risk, Sanofi Pasteur Ltd., Toronto, Ontario, Canada
| | | | - Kui Huang
- Global Medical Epidemiology, Worldwide Medical and Safety, Pfizer Inc., New York, New York, United States of America
| | | | - Sonali Kochhar
- Global Healthcare Consulting, New Delhi, India.,Department of Global Health, University of Washington, Seattle, Washington, USA
| | - Robert T Chen
- Brighton Collaboration, The Task Force for Global Health, Decatur, Georgia, USA
| | - Nicole L Pratt
- Quality Use of Medicines and Pharmacy Research Centre, Clinical and Health Sciences, University of South Australia, Adelaide, South Australia, Australia
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Puente Gómez I, Verheust C, Hanssens L, Dolhain J. Safety profile of Infanrix hexa – 17 years of GSK’s passive post-marketing surveillance. Expert Rev Vaccines 2020; 19:771-779. [DOI: 10.1080/14760584.2020.1800458] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
| | | | - Linda Hanssens
- GSK, Wavre, Belgium
- Miltenyi Biomedicine, Bergisch Gladbach, North Rhine-Westphalia, Germany
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Fatal outcomes following immunization errors as reported to the EudraVigilance: A case series. Vaccine 2020; 38:3086-3095. [PMID: 32147297 DOI: 10.1016/j.vaccine.2020.02.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/19/2020] [Accepted: 02/24/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Serious adverse reactions after immunization are rare but do occur. In very rare instances, cases with fatal outcome have been reported. These reports can have a huge impact and even more so when due to an immunization error. The aim of this study is to systematically review immunization errors with fatal outcomes in EudraVigilance. METHODS This was a case-series analysis of Individual Case Safety Reports (ICSRs) reporting immunization errors and a fatal outcome. To determine the level of certainty of a causal association between the immunization errors and fatal outcomes two independent reviewers assessed all ICSRs using the WHO tool "Causality assessment of an Adverse Event Following Immunization (AEFI)". In accordance with the tool, the ICSRs were classified as consistent, indeterminate, inconsistent/coincidental, or unclassifiable. In addition, we estimated the contribution of reported errors to the fatal outcomes as large, moderate, small, none, or unclassifiable using a classification developed for this study. RESULTS A total of 154 ICSRs met the inclusion criteria. Vaccines reported most frequently were pneumococcal (33), rabies (27) and influenza vaccines (24). Most frequently reported errors were non-compliance with recommended schedules of immunization (63). The most frequently reported vaccine-error combination was rabies vaccines and non-compliance with a recommended schedule of immunization (23). Twelve cases were classified as consistent with causal association and had a large error contribution. These cases concerned a cluster of six cases reporting incorrect handling of multi-dose vials containing measles vaccine and six cases reporting administration of live-attenuated vaccines to immunocompromised patients. DISCUSSION In this study, we showed that fatal outcomes following immunization errors are very rare. Four key issues were the importance of: (1) quality control of multi-dose vaccines, (2) screening patients for immunocompromising factors, (3) education on the importance of adherence, and (4) measures to improve distinction between vaccines and medicines.
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Moro PL, Perez-Vilar S, Lewis P, Bryant-Genevier M, Kamiya H, Cano M. Safety Surveillance of Diphtheria and Tetanus Toxoids and Acellular Pertussis (DTaP) Vaccines. Pediatrics 2018; 142:e20174171. [PMID: 29866795 PMCID: PMC6476554 DOI: 10.1542/peds.2017-4171] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the safety of currently licensed diphtheria-tetanus-acellular pertussis (DTaP) vaccines in the United States by using data from the Vaccine Adverse Event Reporting System (VAERS), a spontaneous reporting surveillance system. METHODS We searched VAERS for US reports of DTaP vaccinations occurring from January 1, 1991, through December 31, 2016, and received by March 17, 2017. We reviewed available medical records for all death reports and a random sample of reports classified as nondeath serious. We used Empirical Bayesian data mining to identify adverse events that were disproportionally reported after DTaP vaccination. RESULTS VAERS received 50 157 reports after DTaP vaccination; 43 984 (87.7%) of them reported concomitant administration of other vaccines, and 5627 (11.2%) were serious. Median age at vaccination was 19 months (interquartile range 35 months). The most frequently reported events were injection site erythema (12 695; 25.3%), pyrexia (9913; 19.8%), injection site swelling (7542; 15.0%), erythema (5599; 11.2%), and injection site warmth (4793; 9.6%). For 3 of the DTaP vaccines, we identified elevated values for vaccination errors using Empirical Bayesian data mining. CONCLUSIONS No new or unexpected adverse events were detected. The observed disproportionate reporting for some nonserious vaccination errors calls for better education of vaccine providers on the specific indications for each of the DTaP vaccines.
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Affiliation(s)
- Pedro L Moro
- Immunization Safety Office, Division of Healthcare Quality Promotion and
| | - Silvia Perez-Vilar
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland; and
| | - Paige Lewis
- Immunization Safety Office, Division of Healthcare Quality Promotion and
| | - Marthe Bryant-Genevier
- Center for Biologics Evaluation and Research, Food and Drug Administration, Silver Spring, Maryland; and
| | - Hajime Kamiya
- Epidemiology Intelligence Service, Meningitis and Vaccine Preventable Diseases Branch, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Maria Cano
- Immunization Safety Office, Division of Healthcare Quality Promotion and
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