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de la Cueva IS, Gerber JE, Hastie A, Brotons C, Panzer F, Pirçon JY, Talsma P, Eckermann T, Nikic V, Gomez XM, Alsdurf H. Enhanced Safety Surveillance of GSK's Inactivated Quadrivalent Seasonal Influenza Vaccine in Belgium, Germany, and Spain During the 2022/2023 Influenza Season. Drug Saf 2024:10.1007/s40264-024-01456-y. [PMID: 38949714 DOI: 10.1007/s40264-024-01456-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND Seasonal influenza is prevented through annual vaccination, especially in children and older adults. These vaccines are annually updated based on World Health Organization recommendations and require continuous safety monitoring. OBJECTIVE We assessed the frequency and severity of adverse events within 7 days of administering GSK's inactivated quadrivalent seasonal influenza vaccine (IIV4) in Belgium, Germany, and Spain during the 2022/2023 influenza season. METHODS In this enhanced safety surveillance study, adults who received GSK's IIV4 and parents/guardians/legally acceptable representatives of vaccinated children (aged 6 months-17 years) were invited to complete adverse drug reaction cards reporting adverse events within 7 days post-vaccination. RESULTS In total, 1332 participants (53.6% female) received at least one dose of GSK's IIV4, including 43 children who received two doses. Overall, 97.8% of adverse drug reaction cards were completed and returned in the study. All participants in Belgium were adults, while 54.7% and 7.4% in Spain and Germany, respectively, were pediatric participants aged 6 months-17 years. After Dose 1, across all age groups, 49.8% of participants reported at least one adverse event. The most common adverse events (cumulative frequency >5%) following Dose 1 were injection-site pain (37.6%), fatigue (15.0%), headache (13.2%), injection-site swelling (9.3%), myalgia (7.6%), and injection-site erythema (7.4%). Across all countries, adverse events were most common in adults aged 18-65 years (59.7%), followed by those aged 3-17 years (47.0%), >65 years (35.7%), and 6-35 months (23.5%). After Dose 2, 18.6% of participants reported at least one adverse event, with general disorders and administration site conditions again being the most frequent. CONCLUSIONS Across all age and risk groups for serious disease, no serious adverse events related to GSK's IIV4 were reported within 7 days post-vaccination. This study supports and confirms the acceptable safety profile of GSK's IIV4 across all recommended age groups. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov number: not applicable.
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Affiliation(s)
| | | | - Andrew Hastie
- GSK, 14200 Shady Grove Road, Rockville, MD, 20850, USA
| | - Carlos Brotons
- Biomedical Research Institute Sant Pau, EAP Sardenya, Barcelona, Spain
| | | | | | - Paul Talsma
- Statistics Department, Vivos Technology Limited (Phastar), London, UK
| | | | - Vanja Nikic
- GSK, 14200 Shady Grove Road, Rockville, MD, 20850, USA
| | - Xavier Martinez Gomez
- Department of Preventive Medicine, Hospital Universitari Vall d'Hebron, Barcelona, Spain
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Dos Santos G, Devadiga R, Kim CS, Bang J. An 8-Year Prospective, Observational, Multi-centre Post-Marketing Safety Surveillance Study Conducted in South Korea (2014-2022) Following the Introduction of GSK's Inactivated Quadrivalent Seasonal Influenza Vaccine (Fluarix Tetra) for Subjects Aged 6 Months and Older. Drug Saf 2024; 47:365-375. [PMID: 38483767 PMCID: PMC10955014 DOI: 10.1007/s40264-024-01395-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2024] [Indexed: 03/21/2024]
Abstract
INTRODUCTION Seasonal influenza is associated with substantial public health burden. The objective of this study was to assess the safety of inactivated quadrivalent seasonal influenza vaccine (IIV4, Fluarix Tetra, GSK, Belgium) in subjects aged ≥ 6 months in Korea. METHODS This prospective, observational, non-comparative, multi-centre post-marketing surveillance study was conducted in Korea in subjects aged ≥ 3 years for 6 years (2014-2020) and extended to subjects aged 6-35 months for 4 years (2018-2022). Subjects received IIV4 in routine clinical practice according to local prescribing information. Adverse events (AEs) were recorded over 21 days post-vaccination. RESULTS The group aged ≥ 3 years included 701 subjects (mean 31.97 years, range 3-86 years, 46.36% male), and the group aged 6-35 months included 687 subjects (mean 16.31 months, 47.02% male). In the group aged ≥ 3 years, 98 subjects (13.98%) reported 140 AEs, of which 42 events in 34 subjects (4.85%) were adverse reactions to vaccine (ARVs). Most of the ARVs were expected, mainly administration site reactions. There were seven mild unexpected ARVs. In the group aged 6-35 months, 248 AEs were reported in 149/687 subjects (21.69%). ARVs were reported in 25/687 subjects (3.64%, 29 events); one was considered unexpected. There were five serious AEs overall, none of which were considered related. CONCLUSION No safety concerns were found during this surveillance study of IIV4 in subjects aged ≥ 6 months in Korea. The findings of this study suggest IIV4 is safe and well tolerated for use in all age groups with a vaccine indication.
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Affiliation(s)
| | | | - Chun Soo Kim
- Department of Pediatrics, Keimyung University School of Medicine, Daegu, South Korea
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Tsang RSM, Agrawal U, Joy M, Byford R, Robertson C, Anand SN, Hinton W, Mayor N, Kar D, Williams J, Victor W, Akbari A, Bradley DT, Murphy S, O’Reilly D, Owen RK, Chuter A, Beggs J, Howsam G, Sheikh A, Richard Hobbs FD, de Lusignan S. Adverse events after first and second doses of COVID-19 vaccination in England: a national vaccine surveillance platform self-controlled case series study. J R Soc Med 2024; 117:134-148. [PMID: 37921538 PMCID: PMC11100448 DOI: 10.1177/01410768231205430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 09/17/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVES To estimate the incidence of adverse events of interest (AEIs) after receiving their first and second doses of coronavirus disease 2019 (COVID-19) vaccinations, and to report the safety profile differences between the different COVID-19 vaccines. DESIGN We used a self-controlled case series design to estimate the relative incidence (RI) of AEIs reported to the Oxford-Royal College of General Practitioners national sentinel network. We compared the AEIs that occurred seven days before and after receiving the COVID-19 vaccinations to background levels between 1 October 2020 and 12 September 2021. SETTING England, UK. PARTICIPANTS Individuals experiencing AEIs after receiving first and second doses of COVID-19 vaccines. MAIN OUTCOME MEASURES AEIs determined based on events reported in clinical trials and in primary care during post-license surveillance. RESULTS A total of 7,952,861 individuals were vaccinated with COVID-19 vaccines within the study period. Among them, 781,200 individuals (9.82%) presented to general practice with 1,482,273 AEIs. Within the first seven days post-vaccination, 4.85% of all the AEIs were reported. There was a 3-7% decrease in the overall RI of AEIs in the seven days after receiving both doses of Pfizer-BioNTech BNT162b2 (RI = 0.93; 95% CI: 0.91-0.94) and 0.96; 95% CI: 0.94-0.98), respectively) and Oxford-AstraZeneca ChAdOx1 (RI = 0.97; 95% CI: 0.95-0.98) for both doses), but a 20% increase after receiving the first dose of Moderna mRNA-1273 (RI = 1.20; 95% CI: 1.00-1.44)). CONCLUSIONS COVID-19 vaccines are associated with a small decrease in the incidence of medically attended AEIs. Sentinel networks could routinely report common AEI rates, which could contribute to reporting vaccine safety.
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Affiliation(s)
- Ruby SM Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Utkarsh Agrawal
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, G1 1XH, UK
- Public Health Scotland, Glasgow, G2 6QE, UK
| | - Sneha N Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - William Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Nikhil Mayor
- Royal Surrey NHS Foundation Trust, Guildford, GU2 7XX, UK
| | - Debasish Kar
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - John Williams
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - William Victor
- Royal College of General Practitioners, London, NW1 2FB, UK
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, SA2 8QA, UK
| | - Declan T Bradley
- Centre for Public Health, Queen’s University Belfast, Belfast, BT12 6BA, UK
- Public Health Agency, Belfast, BT2 8BS, UK
| | - Siobhan Murphy
- Centre for Public Health, Queen’s University Belfast, Belfast, BT12 6BA, UK
| | - Dermot O’Reilly
- Centre for Public Health, Queen’s University Belfast, Belfast, BT12 6BA, UK
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Swansea University, Swansea, SA2 8QA, UK
| | - Antony Chuter
- BREATHE – The Health Data Research Hub for Respiratory Health, Edinburgh, EH16 4SS, UK
| | - Jillian Beggs
- BREATHE – The Health Data Research Hub for Respiratory Health, Edinburgh, EH16 4SS, UK
| | - Gary Howsam
- Royal College of General Practitioners, London, NW1 2FB, UK
| | - Aziz Sheikh
- Usher Institute, University of Edinburgh, Edinburgh, EH16 4SS, UK
| | - FD Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, G1 1XH, UK
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Donners R, Gehweiler J, Kovacs B, Breit HC, Daikeler T, Harder D, Berger CT. Chronic stage magnetic resonance imaging findings in patients with shoulder injury related to vaccine administration (SIRVA). Skeletal Radiol 2023; 52:1695-1701. [PMID: 37012390 PMCID: PMC10069733 DOI: 10.1007/s00256-023-04334-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/20/2023] [Accepted: 03/25/2023] [Indexed: 04/05/2023]
Abstract
PURPOSE Identify chronic shoulder MRI findings in patients with known shoulder injury related to vaccine administration (SIRVA). MATERIALS AND METHODS Two fellowship-trained musculoskeletal radiologists retrospectively reviewed the MRI of nine patients with clinically established SIRVA. MRI was performed at least 4 weeks after vaccination and included intravenous contrast-enhanced sequences. MRI was reviewed for the presence of erosions, tendonitis, capsulitis, synovitis, bone marrow oedema, joint effusion, bursitis, cartilage defects, rotator cuff lesions, and lymphadenopathy. The number and location of focal lesions were recorded. RESULTS Erosions of the greater tuberosity were present in 8/9 (89%), tendonitis of the infraspinatus muscle tendon in 7/9 (78%), capsulitis, synovitis, and bone marrow oedema in 5/9 (56%) cases, respectively. Effusion was found in three, and subdeltoid bursitis, rotator cuff lesions as well as cartilage defects in one patient, respectively. None of our included subjects showed axillary lymphadenopathy. CONCLUSION In this case series, greater humeral tuberosity erosions, infraspinatus muscle tendonitis, capsulitis, synovitis, and bone marrow oedema were common MRI findings in chronic SIRVA.
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Affiliation(s)
- Ricardo Donners
- Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
| | - Julian Gehweiler
- Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
| | - Balazs Kovacs
- Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
| | - Hanns-Christian Breit
- Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
| | - Thomas Daikeler
- Rheumatology Clinic, University Hospital Basel, Basel, Switzerland
- University Centre for Immunology, University Hospital Basel, Basel, Switzerland
| | - Dorothee Harder
- Department of Radiology, University Hospital Basel, Petersgraben 4, CH-4031, Basel, Switzerland
| | - Christoph T Berger
- Rheumatology Clinic, University Hospital Basel, Basel, Switzerland
- University Centre for Immunology, University Hospital Basel, Basel, Switzerland
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Dos Santos G, Eckermann T, Martínez‐Gómez X, Parra J, Nwoji U, Salamanca de la Cueva I. Enhanced safety surveillance of GSK's quadrivalent seasonal influenza vaccine in Germany and Spain (2021/2022 season) using an electronic patient-reported outcome system for vaccine safety remote monitoring. Influenza Other Respir Viruses 2023; 17:e13098. [PMID: 36991538 PMCID: PMC10040952 DOI: 10.1111/irv.13098] [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: 12/14/2022] [Accepted: 01/10/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Seasonal influenza epidemics are managed through vaccination each winter in the European Union, to prevent infections, complications, and deaths. As circulating virus strains vary unpredictably, vaccines are reformulated annually, and their safety monitored rapidly and continuously at the start of each season, following European Medicines Agency guidelines.Seasonal influenza epidemics are managed through vaccination each winter in the European Union, to prevent infections, complications, and deaths. As circulating virus strains vary unpredictably, vaccines are reformulated annually, and their safety monitored rapidly and continuously at the start of each season, following European Medicines Agency guidelines. METHODS This enhanced safety surveillance study assessed pre-specified and other adverse events (AEs) occurring within 7 days of GSK's inactivated quadrivalent seasonal influenza vaccine (IIV4) in children and adults in Spain and Germany. As the study was conducted during the COVID-19 pandemic (2021/2022 season), data were collected electronically, using a web portal or call center. RESULTS Safety was assessed in 737 participants (median age 49 and 9 years in Germany and Spain, respectively, 19.3% with a chronic medical condition). After Dose 1 and Dose 2, respectively, 332 (45.1%) and 5 (26.3%) participants reported at least one AE, primarily pre-specified AEs. The most common AEs after Dose 1 (adults and children) were injection site pain, swelling or erythema, headache, and fatigue. After Dose 2 (in children), the most common AEs were injection site pain, rhinorrhea, fatigue, and decreased appetite. No new or unexpected safety issues were identified. CONCLUSION This study supports and confirms the safety profile of GSK's IIV4 in all age groups with a vaccine indication. The new electronic safety reporting method (with response rates of 75.4% following Dose 1 and 100% following Dose 2) provides an alternative for future studies to reduce the burden on sites or in case site visits are not feasible.
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Tsang RSM, Joy M, Byford R, Robertson C, Anand SN, Hinton W, Mayor N, Kar D, Williams J, Victor W, Akbari A, Bradley DT, Murphy S, O’Reilly D, Owen RK, Chuter A, Beggs J, Howsam G, Sheikh A, Hobbs FDR, de Lusignan S. Adverse events following first and second dose COVID-19 vaccination in England, October 2020 to September 2021: a national vaccine surveillance platform self-controlled case series study. Euro Surveill 2023; 28:2200195. [PMID: 36695484 PMCID: PMC9853944 DOI: 10.2807/1560-7917.es.2023.28.3.2200195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BackgroundPost-authorisation vaccine safety surveillance is well established for reporting common adverse events of interest (AEIs) following influenza vaccines, but not for COVID-19 vaccines.AimTo estimate the incidence of AEIs presenting to primary care following COVID-19 vaccination in England, and report safety profile differences between vaccine brands.MethodsWe used a self-controlled case series design to estimate relative incidence (RI) of AEIs reported to the national sentinel network, the Oxford-Royal College of General Practitioners Clinical Informatics Digital Hub. We compared AEIs (overall and by clinical category) 7 days pre- and post-vaccination to background levels between 1 October 2020 and 12 September 2021.ResultsWithin 7,952,861 records, 781,200 individuals (9.82%) presented to general practice with 1,482,273 AEIs, 4.85% within 7 days post-vaccination. Overall, medically attended AEIs decreased post-vaccination against background levels. There was a 3-7% decrease in incidence within 7 days after both doses of Comirnaty (RI: 0.93; 95% CI: 0.91-0.94 and RI: 0.96; 95% CI: 0.94-0.98, respectively) and Vaxzevria (RI: 0.97; 95% CI: 0.95-0.98). A 20% increase was observed after one dose of Spikevax (RI: 1.20; 95% CI: 1.00-1.44). Fewer AEIs were reported as age increased. Types of AEIs, e.g. increased neurological and psychiatric conditions, varied between brands following two doses of Comirnaty (RI: 1.41; 95% CI: 1.28-1.56) and Vaxzevria (RI: 1.07; 95% CI: 0.97-1.78).ConclusionCOVID-19 vaccines are associated with a small decrease in medically attended AEI incidence. Sentinel networks could routinely report common AEI rates, contributing to reporting vaccine safety.
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Affiliation(s)
- Ruby SM Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Chris Robertson
- Department of Mathematics and Statistics, University of Strathclyde, Glasgow, United Kingdom,Public Health Scotland, Glasgow, United Kingdom
| | - Sneha N Anand
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - William Hinton
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Nikhil Mayor
- Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Debasish Kar
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - John Williams
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - William Victor
- Royal College of General Practitioners, London, United Kingdom
| | - Ashley Akbari
- Population Data Science, Swansea University Medical School, Swansea University, United Kingdom
| | - Declan T Bradley
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom,Public Health Agency, Belfast, United Kingdom
| | - Siobhan Murphy
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Dermot O’Reilly
- Centre for Public Health, Queen’s University Belfast, Belfast, United Kingdom
| | - Rhiannon K Owen
- Population Data Science, Swansea University Medical School, Swansea University, United Kingdom
| | - Antony Chuter
- BREATHE – The Health Data Research Hub for Respiratory Health, Edinburgh, United Kingdom
| | - Jillian Beggs
- BREATHE – The Health Data Research Hub for Respiratory Health, Edinburgh, United Kingdom
| | - Gary Howsam
- Royal College of General Practitioners, London, United Kingdom
| | - Aziz Sheikh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - FD Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom,Royal College of General Practitioners, London, United Kingdom
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Moeller-Arendt M, van de Witte S, Nauta J, de Voogd H, Rogoll J, Nisslein T. Enhanced passive safety surveillance of Influvac® and Influvac® Tetra: Results from seven consecutive seasons. Vaccine 2023; 41:606-613. [PMID: 36517322 DOI: 10.1016/j.vaccine.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND OBJECTIVES In 2014, the European Medicines Agency (EMA) set out requirements for an enhanced safety surveillance for seasonal influenza vaccines. This paper presents data from the yearly Enhanced Passive Safety Surveillance (EPSS) implemented for Influvac® since season 2014/15 and continued for Influvac® Tetra from season 2018/19 onwards. METHODS In seven consecutive seasons, an EPSS, aiming for at least 1,000 vaccinees (additional target of 100 vaccinees per five predefined age groups), was conducted in Germany, where market characteristics were expected to allow for a quick generation of representative data. Reactogenicity data in terms of reporting rates, severity and duration of pre-specified local and systemic adverse events of interest (AEI) were collected using response cards, which were completed by vaccinees and returned seven days after vaccination via regular mail. In addition, response cards contained a call center number to enhance reporting of other than pre-specified adverse events. RESULTS The primary target of at least 1,000 vaccinees was surpassed in all seasons, as was the additional target of 100 adults and elderly. Reactogenicity data were in line with known safety profile of Influvac® and Influvac® Tetra. In children, the target was mostly met in seasons when the EPSS was conducted for Influvac®, but not in seasons when it was conducted for Influvac® Tetra. Although the data for Influvac® Tetra are based on a low number of paediatric vaccinees, they do not indicate a different reactogenicity profile of Influvac® Tetra compared with Influvac®. No signals were identified. CONCLUSION The EPSS set up for Influvac® and Influvac® Tetra proved a robust and effective methodology to comply with the objectives of EMÁ's guidance on enhanced safety surveillance of seasonal influenza vaccines. Safety data from seven consecutive seasons confirmed the favourable safety profile of both vaccines.
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Affiliation(s)
| | | | - Jos Nauta
- Abbott Healthcare Products B.V, Weesp, the Netherlands
| | | | - Jutta Rogoll
- Global Pharmacovigilance, Abbott Laboratories, Hannover, Germany
| | - Thomas Nisslein
- Global Pharmacovigilance, Abbott Laboratories, Hannover, Germany
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Bauwens J, de Lusignan S, Weldesselassie YG, Sherlock J, Künzli N, Bonhoeffer J. Safety of routine childhood vaccine coadministration versus separate vaccination. BMJ Glob Health 2022; 7:bmjgh-2021-008215. [PMID: 36162867 PMCID: PMC9516064 DOI: 10.1136/bmjgh-2021-008215] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 08/13/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION As new vaccines are developed more vaccine coadministrations vaccines are being offered to make delivery more practical for health systems and patients. We compared the safety of coadministered vaccines with separate vaccination for 20 coadministrations by considering nine types of adverse events following immunisation (AEFI). METHODS Real-life immunisation and adverse event data for this observational cohort study were extracted from the Oxford-Royal College of General Practitioners Research and Surveillance Centre for children registered in the database between 2008 and 2018. We applied the self-controlled case series method to calculate relative incidence ratios (RIR) for AEFI. These RIRs compare the RI of AEFI following coadministration with the RI following separate administration of the same vaccines. RESULTS We assessed 3 518 047 adverse events and included 5 993 290 vaccine doses given to 958 591 children. 17% of AEFI occurred less and 11% more frequently following coadministration than would have been expected based on the RIs following separate vaccinations, while there was no significant difference for 72% of AEFI. We found amplifying interaction effects for AEFI after five coadministrations comprising three vaccines: for fever (RIR 1.93 (95% CI 1.63 to 2.29)), rash (RIR 1.49 (95% CI 1.29 to 1.74)), gastrointestinal events (RIR 1.31 (95% CI 1.14 to 1.49)) and respiratory events (RIR 1.27 (1.17-1.38)) following DTaP/IPV/Hib+MenC+ PCV; gastrointestinal events (RIR 1.65 (95% CI 1.35 to 2.02)) following DTaP/IPV/Hib+MenC+ RV; fever (RIR 1.44 (95% CI 1.09 to 1.90)) and respiratory events (RIR 1.40 (95% CI 1.25 to 1.57)) following DTaP/IPV/Hib+PCV+ RV; gastrointestinal (RIR 1.48 (95% CI 1.20 to 1.82)) and respiratory events (RIR 1.43 (95% CI 1.26 to 1.63)) following MMR+Hib/MenC+PCV; gastrointestinal events (RIR 1.68 (95% CI 1.07 to 2.64)) and general symptoms (RIR 11.83 (95% CI 1.28 to 109.01)) following MMR+MenC+PCV. Coadministration of MMR+PCV led to more fever (RIR 1.91 (95% CI 1.83 to 1.99)), neurological events (RIR 2.04 (95% CI 1.67 to 2.49)) and rash (RIR 1.06 (95% CI 1.01 to 1.11)) compared with separate administration, DTaP/IPV/Hib+MMR to more musculoskeletal events (RIR 3.56 (95% CI 1.21 to 10.50)) and MMR+MenC to more fever (RIR 1.58 (95% CI 1.37 to 1.82)). There was no indication that unscheduled coadministrations are less safe than scheduled coadministrations. CONCLUSION Real-life RIRs of AEFI justify coadministering routine childhood vaccines according to the immunisation schedule. Further research into the severity of AEFI following coadministration is required for a complete understanding of the burden of these AEFI.
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Affiliation(s)
- Jorgen Bauwens
- University of Basel Children's Hospital, Basel, Switzerland .,University of Basel, Basel, Switzerland
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK.,Royal College of General Practitioners, London, UK
| | | | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UK
| | - Nino Künzli
- University of Basel, Basel, Switzerland.,Swiss Tropical and Public Health Institute, Basel, Switzerland
| | - Jan Bonhoeffer
- University of Basel Children's Hospital, Basel, Switzerland
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Dos Santos G, Wang H, Jindal P, Rybo M, Roul H, Pallem S, Eckermann T, Godderis L, Martínez Gómez X, Godard E, Soler M, Yousefi M, Salamanca de la Cueva I, Nwoji U. Brand-Specific Enhanced Safety Surveillance Study of GSK's Quadrivalent Seasonal Influenza Vaccine, Conducted During the COVID-19 Pandemic, in Belgium, Germany and Spain, for the 2020/21 Season. Infect Dis Ther 2021; 11:463-483. [PMID: 34961900 PMCID: PMC8711683 DOI: 10.1007/s40121-021-00571-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/17/2021] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Seasonal influenza poses a major public health burden worldwide. Influenza vaccines, updated yearly to match circulating strains based on World Health Organization (WHO) recommendations, are the cornerstone of prevention and require regular monitoring. The COVID-19 pandemic is expected to cause logistical, site access and medical staff constraints and could affect the safety profile of influenza vaccines. METHODS Following European Medicines Agency guidance, an enhanced safety surveillance (ESS) study assessed the frequency and severity of predefined and other adverse events (AEs) occurring within 7 days of receiving GSK's inactivated quadrivalent seasonal influenza vaccine (IIV4), in Belgium, Germany and Spain in 2020/21, using adverse drug reaction (ADR) cards. RESULTS During the 2020/21 influenza season, 1054 participants vaccinated with GSK's IIV4 were enrolled (all adults in Belgium and Germany, 30% adults/70% children in Spain); 96 eligible children received a second dose. Overall, 1042 participants completed the study. After doses 1 and 2, 98.9% and 100% of participants, respectively, returned their completed ADR card. After doses 1 and 2, 37.8% (398/1054) and 13.5% (13/96) of participants, respectively, reported at least one AE. The most frequently reported categories of AEs were "general disorders and administration site conditions" (e.g. injection site pain) and "nervous system disorders" (e.g. headache). There were no deaths or serious AEs deemed related to GSK's IIV4. CONCLUSION This ESS study assessed AEs in near real time. The COVID-19 pandemic did not alter the safety profile of GSK's IIV4. No safety signals were detected during the study, which confirms the excellent safety profile of GSK's IIV4.
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Affiliation(s)
| | | | - Pooja Jindal
- Parexel International, Chandigarh, India, C/O GSK, Rockville, MD, USA
| | | | - Hélène Roul
- Keyrus Life Science, Levallois-Perret, France, C/O GSK, Wavre, Belgium
| | - Sridevi Pallem
- Keyrus Life Science, New York, NY, USA, C/O GSK, New York, NY, USA
| | | | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium
| | | | | | - Muriel Soler
- 4Clinics, Waterloo, Belgium, C/O GSK, Wavre, Belgium
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10
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Salamanca de la Cueva I, Cinconze E, Eckermann T, Nwoji U, Godderis L, Lu E, Martínez-Gómez X, Wang H, Yanni E. Safety Profile of GSK's Inactivated Quadrivalent Seasonal Influenza Vaccine in Belgium, Germany and Spain: Passive Enhanced Safety Surveillance Study for the 2019/2020 Influenza Season. Drug Saf 2021; 44:1375-1390. [PMID: 34694589 PMCID: PMC8543775 DOI: 10.1007/s40264-021-01121-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2021] [Indexed: 12/04/2022]
Abstract
Introduction Seasonal influenza infects millions annually in Europe. Annual influenza vaccination is the most effective measure to reduce the risk of infection and its complications, especially among young children and older adults. Objective We assessed adverse event (AE) frequency after receiving GSK’s inactivated quadrivalent seasonal influenza vaccine (IIV4). Methods A passive enhanced safety surveillance study was conducted in Belgium, Germany, and Spain. Adults who had received GSK's IIV4 or the parent(s)/guardian(s)/legally acceptable representative(s) of children given the vaccine were invited to complete an adverse drug reaction (ADR) card to document AEs experienced within 7 days post vaccination. Results A total of 1082 participants (51.6% females) received GSK's IIV4, including 115 children < 9 years of age who received two doses. The ADR card return rate was 97.0% (n = 1049) after dose 1 and 100% (n = 115) after dose 2. All participants in Belgium and Germany were adults. In Spain, 71.2% were children. After dose 1, 39.2% reported one or more AE. The most frequent AEs category was "general disorders and administration site conditions” (GDASC). AEs were most frequently reported in adults aged 18–65 years (47.2%), followed by children aged 6 months–17 years (38.1%), and adults aged > 65 years (31.6%). After dose 2, 7.8% reported one or more AE, and GDASC was again the most frequent AE category. There were no serious AEs related to GSK's IIV4 within 7 days post vaccination. Conclusion No serious AEs related to GSK’s IIV4 within 7 days post vaccination were reported. This study supports the favourable risk–benefit safety profile of GSK’s IIV4. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-021-01121-8. Seasonal influenza infects millions annually in Europe, especially young children and older adults. Annual influenza vaccination is the most effective measure to reduce the risk of infection and its complications. As the wild influenza virus strains change every year, the composition of the influenza vaccine changes as well. Since the vaccine is produced in the same way over the years, extensive safety studies are no longer required by regulatory authorities. Instead, monitoring of any unwanted medical incidents (adverse events) after vaccination is required. For the 2019/2020 season, we monitored the adverse events reported by a representative sample of people in Belgium, Germany, and Spain within 7 days after receiving GSK's seasonal influenza vaccine. Of the 1082 people who received the first dose of the vaccine, 39% reported at least one adverse event, such as pain and swelling at the injection site, tiredness, fever, headache, or dizziness. A total of 115 children under 9 years of age received two doses 4 weeks apart. After their second dose, few of these children (8%) reported adverse events. The most frequent adverse events were fever, swelling and pain at the injection site, runny nose, or irritability. No serious adverse events were reported after either the first or second dose. No serious adverse events related to GSK’s seasonal influenza vaccine within the 7 days after vaccination were reported. This study supports the favourable risk–benefit safety profile of GSK's seasonal influenza vaccine.
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Affiliation(s)
| | | | | | | | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Louvain, Belgium
- External Service for Prevention and Protection at Work, IDEWE, Heverlee, Belgium
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11
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de Lusignan S, Tsang RSM, Amirthalingam G, Akinyemi O, Sherlock J, Tripathy M, Deeks A, Ferreira F, Howsam G, Hobbs FDR, Joy M. Adverse events of interest following influenza vaccination, a comparison of cell culture-based with egg-based alternatives: English sentinel network annual report paper 2019/20. LANCET REGIONAL HEALTH-EUROPE 2021; 2:100029. [PMID: 34557791 PMCID: PMC8454842 DOI: 10.1016/j.lanepe.2021.100029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background The cell-based quadrivalent influenza vaccine (QIVc) is now offered as an alternative to egg-based quadrivalent (QIVe) and adjuvanted trivalent (aTIV) influenza vaccines in the UK. While post-licensure studies show non-inferiority of cell-based vaccines, it is not known how its safety profile compares to other types of vaccines in real-world use. Methods We conducted a retrospective cohort study using computerised medical records from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) sentinel network database. We used a self-controlled case series design and calculated the relative incidence (RI) of adverse events of interest (AEIs) over different risk periods. We then compared the RIs of AEIs within seven days of vaccination overall and between QIVc and QIVe in the 18–64 years age group, and between QIVc and aTIV in the ≥65 years age group. Findings The majority of AEIs occurred within seven days of vaccination, and a seasonal effect was observed. Using QIVc as the reference group, QIVe showed similar incidence of AEIs whereas live attenuated influenza vaccine (LAIV) and aTIV had lower incidence of AEIs. In the stratified analyses, QIVe and aTIV were associated with a 16% lower incidence of AEIs in the seven days post-vaccination in both the 18–64 years and ≥65 years age groups. Interpretation Routine sentinel network data allow comparisons of safety profiles of equally suitable seasonal influenza vaccines. The higher incidence of AEIs associated with QIVc suggest monitoring of several seasons would allow robust comparisons to be made. Funding Public Health England.
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Affiliation(s)
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom.,Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, United Kingdom
| | - Ruby S M Tsang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | | | - Oluwafunmi Akinyemi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Manasa Tripathy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Alexandra Deeks
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Gary Howsam
- Royal College of General Practitioners Research and Surveillance Centre, 30 Euston Square, London NW1 2FB, United Kingdom
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Woodstock Road, Oxford OX2 6GG, United Kingdom
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12
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Hirsiger JR, Tamborrini G, Harder D, Bantug GR, Hoenger G, Recher M, Marx C, Li QZ, Martin I, Hess C, Scherberich A, Daikeler T, Berger CT. Chronic inflammation and extracellular matrix-specific autoimmunity following inadvertent periarticular influenza vaccination. J Autoimmun 2021; 124:102714. [PMID: 34403915 DOI: 10.1016/j.jaut.2021.102714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/27/2021] [Accepted: 08/05/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Viral infections may trigger autoimmunity in genetically predisposed individuals. Immunizations mimic viral infections immunologically, but only in rare instances vaccinations coincide with the onset of autoimmunity. Inadvertent vaccine injection into periarticular shoulder tissue can cause inflammatory tissue damage ('shoulder injury related to vaccine administration, SIRVA). Thus, this accident provides a model to study if vaccine-induced pathogen-specific immunity accompanied by a robust inflammatory insult may trigger autoimmunity in specific genetic backgrounds. METHODS We studied 16 otherwise healthy adults with suspected SIRVA occurring following a single work-related influenza immunization campaign in 2017. We performed ultrasound, immunophenotypic analyses, HLA typing, and influenza- and self-reactivity functional immunoassays. Vaccine-related bone toxicity and T cell/osteoclast interactions were assessed in vitro. FINDINGS Twelve of the 16 subjects had evidence of inflammatory tissue damage on imaging, including bone erosions in six. Tissue damage was associated with a robust peripheral blood T and B cell activation signature and extracellular matrix-reactive autoantibodies. All subjects with erosions were HLA-DRB1*04 positive and showed extracellular matrix-reactive HLA-DRB1*04 restricted T cell responses targeting heparan sulfate proteoglycan (HSPG). Antigen-specific T cells potently activated osteoclasts via RANK/RANK-L, and the osteoclast activation marker Trap5b was high in sera of patients with an erosive shoulder injury. In vitro, the vaccine component alpha-tocopheryl succinate recapitulated bone toxicity and stimulated osteoclasts. Auto-reactivity was transient, with no evidence of progression to rheumatoid arthritis or overt autoimmune disease. CONCLUSION Vaccine misapplication, potentially a genetic predisposition, and vaccine components contribute to SIRVA. The association with autoimmunity risk allele HLA-DRB1*04 needs to be further investigated. Despite transient autoimmunity, SIRVA was not associated with progression to autoimmune disease during two years of follow-up.
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Affiliation(s)
- Julia R Hirsiger
- Translational Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Giorgio Tamborrini
- Ultrasound Center for Rheumatology (UZR), Basel, Switzerland; Rheumatology Clinic, University Hospital Basel, Basel, Switzerland
| | - Dorothee Harder
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Glenn R Bantug
- Immunobiology Lab, Department Biomedicine, University of Basel, Basel, Switzerland
| | - Gideon Hoenger
- HLA-Diagnostics and Immunogenetics, Department of Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Mike Recher
- Immunodeficiency Lab, Department Biomedicine, University of Basel, Basel, Switzerland
| | | | - Quan-Zhen Li
- Department of Immunology & Internal Medicine, IIMT Microarray Core Facility, University of Texas Southwestern Medical Center, USA
| | - Ivan Martin
- Laboratory of Tissue Engineering, Departments of Surgery and Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Christoph Hess
- Immunobiology Lab, Department Biomedicine, University of Basel, Basel, Switzerland
| | - Arnaud Scherberich
- Laboratory of Tissue Engineering, Departments of Surgery and Biomedicine, University Hospital of Basel, University of Basel, Basel, Switzerland
| | - Thomas Daikeler
- Rheumatology Clinic, University Hospital Basel, Basel, Switzerland
| | - Christoph T Berger
- Translational Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland; Interdisciplinary Center for Immunology, Departments of Dermatology, Internal Medicine, and Rheumatology, University Hospital Basel, Basel, Switzerland.
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13
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de Lusignan S, Lopez Bernal J, Byford R, Amirthalingam G, Ferreira F, Akinyemi O, Andrews N, Campbell H, Dabrera G, Deeks A, Elliot AJ, Krajenbrink E, Liyanage H, McGagh D, Okusi C, Parimalanathan V, Ramsay M, Smith G, Tripathy M, Williams J, Victor W, Zambon M, Howsam G, Nicholson BD, Tzortziou Brown V, Butler CC, Joy M, Hobbs FDR. Influenza and Respiratory Virus Surveillance, Vaccine Uptake, and Effectiveness at a Time of Cocirculating COVID-19: Protocol for the English Primary Care Sentinel System for 2020-2021. JMIR Public Health Surveill 2021; 7:e24341. [PMID: 33605892 PMCID: PMC7899204 DOI: 10.2196/24341] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 11/13/2020] [Accepted: 12/08/2020] [Indexed: 12/12/2022] Open
Abstract
Background The Oxford–Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) and Public Health England (PHE) are commencing their 54th season of collaboration at a time when SARS-CoV-2 infections are likely to be cocirculating with the usual winter infections. Objective The aim of this study is to conduct surveillance of influenza and other monitored respiratory conditions and to report on vaccine uptake and effectiveness using nationally representative surveillance data extracted from primary care computerized medical records systems. We also aim to have general practices collect virology and serology specimens and to participate in trials and other interventional research. Methods The RCGP RSC network comprises over 1700 general practices in England and Wales. We will extract pseudonymized data twice weekly and are migrating to a system of daily extracts. First, we will collect pseudonymized, routine, coded clinical data for the surveillance of monitored and unexpected conditions; data on vaccine exposure and adverse events of interest; and data on approved research study outcomes. Second, we will provide dashboards to give general practices feedback about levels of care and data quality, as compared to other network practices. We will focus on collecting data on influenza-like illness, upper and lower respiratory tract infections, and suspected COVID-19. Third, approximately 300 practices will participate in the 2020-2021 virology and serology surveillance; this will include responsive surveillance and long-term follow-up of previous SARS-CoV-2 infections. Fourth, member practices will be able to recruit volunteer patients to trials, including early interventions to improve COVID-19 outcomes and point-of-care testing. Lastly, the legal basis for our surveillance with PHE is Regulation 3 of the Health Service (Control of Patient Information) Regulations 2002; other studies require appropriate ethical approval. Results The RCGP RSC network has tripled in size; there were previously 100 virology practices and 500 practices overall in the network and we now have 322 and 1724, respectively. The Oxford–RCGP Clinical Informatics Digital Hub (ORCHID) secure networks enable the daily analysis of the extended network; currently, 1076 practices are uploaded. We are implementing a central swab distribution system for patients self-swabbing at home in addition to in-practice sampling. We have converted all our primary care coding to Systematized Nomenclature of Medicine Clinical Terms (SNOMED CT) coding. Throughout spring and summer 2020, the network has continued to collect specimens in preparation for the winter or for any second wave of COVID-19 cases. We have collected 5404 swabs and detected 623 cases of COVID-19 through extended virological sampling, and 19,341 samples have been collected for serology. This shows our preparedness for the winter season. Conclusions The COVID-19 pandemic has been associated with a groundswell of general practices joining our network. It has also created a permissive environment in which we have developed the capacity and capability of the national primary care surveillance systems and our unique public health institute, the RCGP and University of Oxford collaboration.
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Affiliation(s)
- Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Rachel Byford
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Filipa Ferreira
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Oluwafunmi Akinyemi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | | | | | - Alexandra Deeks
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | | | - Harshana Liyanage
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Dylan McGagh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Cecilia Okusi
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Vaishnavi Parimalanathan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mary Ramsay
- Public Health England, London, United Kingdom
| | | | - Manasa Tripathy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - John Williams
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - William Victor
- Royal College of General Practitioners, London, United Kingdom
| | | | - Gary Howsam
- Royal College of General Practitioners, London, United Kingdom
| | - Brian David Nicholson
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | | | - Christopher C Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - Mark Joy
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
| | - F D Richard Hobbs
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom
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14
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Dos Santos G, Nguyen BY, Damaso S, Godderis L, Martínez-Gómez X, Eckermann T, Loos H, Salamanca de la Cueva I, Shende V, Schmidt AC, Yeakey A. Brand-Specific Enhanced Safety Surveillance of GSK's Quadrivalent Seasonal Influenza Vaccine in Belgium, Germany and Spain for the 2018/2019 Season. Drug Saf 2020; 43:265-279. [PMID: 31884676 PMCID: PMC7048703 DOI: 10.1007/s40264-019-00893-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction Seasonal influenza causes numerous deaths worldwide each year. Annual vaccination for disease prevention is crucial. Seasonal vaccines are updated each year to closely match circulating strains. Objective To comply with European Medicines Agency (EMA) guidance, an enhanced safety study was conducted to rapidly collect and assess adverse events (AEs) within 7 days following vaccination with GSK’s inactivated quadrivalent seasonal influenza vaccine (IIV4) in 2018/2019. Methods A customised AE reporting card (AERC) and standardised electronic data reporting application were used in Belgium, Germany and Spain in adult and paediatric subjects in this study. Results In 2018, 1060 subjects vaccinated with one dose of GSK’s IIV4 were enrolled (all subjects in Belgium and Germany were adults, and 75% and 25% of subjects in Spain were children and adults, respectively). In Spain, 139 eligible children later received a second dose. Overall 1035 subjects completed the study. After dose 1 and dose 2, 98.3% and 100% of subjects, respectively, returned the completed AERC. Over the study period, 43.0% (456/1060 post dose 1) and 23.7% (33/139 post dose 2) of subjects reported at least one AE within 7 days after immunisation. The most frequently reported categories of AEs were General and Administration Site (e.g. injection site pain, swelling, erythema) and Respiratory Disorders (e.g. rhinorrhoea, cough, nasal congestion). There were no deaths and no serious AEs deemed related to GSK’s IIV4. Conclusion In compliance with EMA guidance, this study design allowed for near real-time assessment of AEs. No safety signals were detected at any point during the study period. The study supports and confirms the acceptable safety profile of GSK’s IIV4. ClinicalTrials.gov identifier NCT03688620.
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Affiliation(s)
| | | | | | - Lode Godderis
- Environment and Health, Department of Public Health and Primary Care, KU Leuven, Louvain, Belgium
- IDEWE Occupational Health Services, Heverlee-Leuven, Belgium
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