Neurologic complications of immunizations

Tétraplégie flasque après vaccination anti-tétanique

INTRODUCTION

Anti-tetanus vaccination is considered to be very safe. However complications such as mononevritis, multinevritis or even polyradiculonevritis can be encountered.

OBSERVATION

An 85-year-old man was admitted to our unit after a traffic accident caused by stroke. Seventy-two hours later the patient developed tetraplegia within a few hours, caused by neuropathy secondary to anti-tetanus vaccination.

DISCUSSION

In this elderly patient, the rapid onset and severe presentation of the tetraplegia as well as the past history of normal vaccination and the axonal form of the neuropathy could have led to a misdiagnosis of neuropathy after booster anti-tetanus vaccination. We first ruled out other possible diagnoses and then reviewed the possible mechanisms of neurological complications of vaccinations. These complications are probably underestimated in elderly hospitalized patients who receive a booster shot in the emergency department.

CONCLUSION

This report illustrates the importance of reconsidering the benefit/risk relationship of anti-tetanos vaccination.

The global impact of vaccines containing aluminium adjuvants

Immunization against childhood vaccine-preventable diseases has arguably had the greatest impact on the health of children of any public health intervention. Many of the vaccines used in the Expanded Programme on Immunization (EPI) have contained aluminium-based adjuvants. As such, these adjuvants have played a vital role in enabling the basic vaccines to be used effectively. DTP global supply is fragile and could easily be upset through the loss of even one major vaccine manufacturer. Non-aluminium adjuvants could not readily replace aluminium adjuvants. New generation vaccines will probably need new generation adjuvants. The impact of vaccines with adjuvants is discussed. Having provided decades of reliable, safe service in their relatively simple chemical formulations, adjuvants are likely to be with us, in one form or another, for the indefinite future.

Guillain-Barré Syndrome and Vaccination: Usually Unrelated

With the rapid pace of immunologic research, it is more important than ever for readers to understand rational immunodiagnosis, immunoprophylaxis, and immunotherapy. This column is intended to help you carry out proper immunologic drug use in your practice.

Pertussis vaccines

Concern over adverse reactions temporally associated with whole cell pertussis vaccine and advances in the understanding of the Bordetella pertussis organism have led to a new generation of more purified acellular vaccines. The biology of the pertussis organism, epidemiology of disease, vaccine development over the decades, and vaccine efficacy and adverse reaction data from whole cell and acellular vaccine trials are presented. Questions that remain to be answered before acellular vaccine replaces conventional vaccine are defined, and future studies addressing these questions are proposed.