Vasculitis as an adverse event following immunization - Systematic literature review.

Creator(s)

Caterina Bonetto
Francesco Trotta
Patrizia Felicetti
Graciela S. Alarcón
Carmela Santuccio
Novilia Sjafri Bachtiar
Yolanda Brauchli Pernus
Rebecca Chandler
Giampiero Girolomoni
Robert D M Hadden
Merita Kucuku
Seza Ozen
Barbara A. Pahud, Children's Mercy HospitalFollow
Karina Top
Frederick Varricchio
Robert P. Wise
Giovanna Zanoni
Saša Živković
Jan Bonhoeffer
Brighton Collaboration Vasculitis Working Group

Document Type

Article

Publication Date

12-12-2016

Identifier

DOI: 10.1016/j.vaccine.2015.09.026

Abstract

BACKGROUND: Several types of vasculitis have been observed and reported in temporal association with the administration of various vaccines. A systematic review of current evidence is lacking.

OBJECTIVE: This systematic literature review aimed to assess available evidence and current reporting practice of vasculitides as adverse events following immunization (AEFI).

METHODS: We reviewed the literature from 1st January 1994 to 30th June 2014. This review comprises randomized controlled trials, observational studies, case series, case reports, reviews and comments regardless of vaccine and target population.

RESULTS: The initial search resulted in the identification of 6656 articles. Of these, 157 articles were assessed for eligibility and 75 studies were considered for analysis, including 6 retrospective/observational studies, 2 randomized controlled trials, 7 reviews, 11 case series, 46 case reports and 3 comments. Most of the larger, higher quality studies found no causal association between vaccination and subsequent development of vasculitis, including several studies on Kawasaki disease and Henoch-Schönlein purpura (IgA vasculitis). Smaller case series reported a few cases of vasculitis following BCG and vaccines against influenza and hepatitis. Only 24% of the articles reported using a case definition of vasculitis.

CONCLUSIONS: Existing literature does not allow establishing a causative link between vaccination and vasculitides. Further investigations were strengthened by the use of standardized case definitions and methods for data collection, analysis and presentation to improve data comparability and interpretation of vasculitis cases following immunization.

Journal Title

Vaccine

Volume

34

Issue

51

First Page

6641

Last Page

6651

MeSH Keywords

Humans; Immunization; Vasculitis

Keywords

Adverse event following immunization (AEFI); Case definition; Immunization; Systematic review; Vaccine; Vasculitis

Recommended Citation

Bonetto C, Trotta F, Felicetti P, et al. Vasculitis as an adverse event following immunization - Systematic literature review. Vaccine. 2016;34(51):6641-6651. doi:10.1016/j.vaccine.2015.09.026