PMID- 25258101 OWN - NLM STAT- MEDLINE DCOM- 20150615 LR - 20191210 IS - 1873-2518 (Electronic) IS - 0264-410X (Linking) VI - 32 IP - 48 DP - 2014 Nov 12 TI - Post-licensure surveillance of trivalent live attenuated influenza vaccine in adults, United States, Vaccine Adverse Event Reporting System (VAERS), July 2005-June 2013. PG - 6499-504 LID - S0264-410X(14)01277-8 [pii] LID - 10.1016/j.vaccine.2014.09.018 [doi] AB - BACKGROUND: Trivalent live attenuated influenza vaccine (LAIV3) was licensed and recommended for use in 2003 in children and adults 2-49 years of age. Post-licensure safety data have been limited, particularly in adults. METHODS: We searched Vaccine Adverse Event Reporting System (VAERS) for US reports after LAIV3 from July 1, 2005-June 30, 2013 (eight influenza seasons) in adults aged >/= 18 years old. We conducted descriptive analyses and clinically reviewed serious reports (i.e., death, life-threatening illness, hospitalization, prolonged hospitalization, or permanent disability) and reports of selected conditions of interest. We used empirical Bayesian data mining to identify adverse events (AEs) that were reported more frequently than expected. We calculated crude AE reporting rates to VAERS by influenza season. RESULTS: During the study period, VAERS received 1207 LAIV3 reports in adults aged 18-49 years old; 107 (8.9%) were serious, including four death reports. The most commonly reported events were expired drug administered (n=207, 17%), headache (n=192, 16%), and fever (n=133, 11%). The most common diagnostic categories for non-fatal serious reports were neurological (n=40, 39%), cardiovascular (n=14, 14%), and other non-infectious conditions (n=20, 19%). We noted a higher proportion of Guillain-Barre syndrome (GBS) and cardiovascular reports in the Department of Defense (DoD) population compared to the civilian population. Data mining detected disproportional reporting of ataxia (n=15); clinical review revealed that ataxia was a component of diverse clinical entities including GBS. CONCLUSIONS: Review of VAERS reports are reassuring, the only unexpected safety concern for LAIV3 identified was a higher than expected number of GBS reports in the DoD population, which is being investigated. Reports of administration of expired LAIV3 represent administration errors and indicate the need for education, training and screening regarding the approved indications. CI - Published by Elsevier Ltd. FAU - Haber, Penina AU - Haber P AD - Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333, USA. Electronic address: pyh0@cdc.gov. FAU - Moro, Pedro L AU - Moro PL AD - Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333, USA. FAU - McNeil, Michael M AU - McNeil MM AD - Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333, USA. FAU - Lewis, Paige AU - Lewis P AD - Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333, USA. FAU - Woo, Emily Jane AU - Woo EJ AD - Office of Biostatistics and Epidemiology, Center for Biologics Evaluation and Research, Food and Drug Administration, Rockville, MD 20852, USA. FAU - Hughes, Hayley AU - Hughes H AD - Safety and Evaluation Division, Military Vaccine Agency (MILVAX), Falls Church, VA 22042, USA. FAU - Shimabukuro, Tom T AU - Shimabukuro TT AD - Immunization Safety Office, Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), 1600 Clifton Rd NE, Atlanta, GA 30333, USA. LA - eng PT - Journal Article DEP - 20140922 PL - Netherlands TA - Vaccine JT - Vaccine JID - 8406899 RN - 0 (Influenza Vaccines) RN - 0 (Vaccines, Attenuated) SB - IM CIN - J Pediatric Infect Dis Soc. 2015 Mar;4(1):81-2. PMID: 26407364 MH - Adolescent MH - Adult MH - Adverse Drug Reaction Reporting Systems/*statistics & numerical data MH - Bayes Theorem MH - Centers for Disease Control and Prevention, U.S. MH - Data Mining MH - Drug-Related Side Effects and Adverse Reactions/*epidemiology MH - Female MH - Humans MH - Influenza Vaccines/*adverse effects MH - Male MH - Middle Aged MH - *Product Surveillance, Postmarketing MH - United States/epidemiology MH - United States Food and Drug Administration MH - Vaccines, Attenuated/adverse effects MH - Young Adult OTO - NOTNLM OT - Live attenuated influenza vaccine OT - Post-licensure surveillance OT - Vaccine safety EDAT- 2014/09/27 06:00 MHDA- 2015/06/16 06:00 CRDT- 2014/09/27 06:00 PHST- 2014/07/23 00:00 [received] PHST- 2014/09/09 00:00 [revised] PHST- 2014/09/11 00:00 [accepted] PHST- 2014/09/27 06:00 [entrez] PHST- 2014/09/27 06:00 [pubmed] PHST- 2015/06/16 06:00 [medline] AID - S0264-410X(14)01277-8 [pii] AID - 10.1016/j.vaccine.2014.09.018 [doi] PST - ppublish SO - Vaccine. 2014 Nov 12;32(48):6499-504. doi: 10.1016/j.vaccine.2014.09.018. Epub 2014 Sep 22.