RISKS OF CONVULSION AND ASEPTIC MENINGITIS FOLLOWING MEASLES-MUMPS-RUBELLA VACCINATION IN THE UNITED KINGDOM

Am J Epidemiol. 2007 Mar 15;165(6):704-9. Epub 2007 Jan 4.

Miller E, Andrews N, Stowe J, Grant A, Waight P, Taylor B.

Source

Immunisation Department, Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London, UK. liz.miller@hpa.org.uk

Abstract

Measles-mumps-rubella (MMR) vaccines containing the Urabe strain of mumps were withdrawn in the United Kingdom in 1992 following demonstration of an increased risk of aseptic meningitis 15-35 days after vaccination. Following introduction of a replacement MMR vaccine (Priorix; GlaxoSmithKline, London, United Kingdom) in 1998, active surveillance of aseptic meningitis and convulsion was established to evaluate the risk associated with the new vaccine. No laboratory-confirmed cases of mumps meningitis were detected among children aged 12-23 months after administration of 1.6 million doses of Priorix (upper 95% confidence limit of risk: 1:437,000) in England and Wales. The upper 95% confidence limit excluded the risk found for mumps meningitis with Urabe vaccines (1:143,000 doses). No cases of aseptic meningitis were detected among children aged 12-23 months, who had received over 99,000 doses of Priorix (upper 95% confidence limit of risk: 1:27,000), in a regional database of hospital-admitted cases. This compares with an observed risk of 1:12,400 for Urabe vaccines. An elevated relative incidence of convulsion was found in the 6- to 11-day period after receipt of Priorix (relative incidence = 6.26, 95% confidence interval: 3.85, 10.18)-consistent with the known effects of the measles component of MMR vaccine-but not in the 15- to 35-day period (relative incidence = 1.48, 95% confidence interval: 0.88, 2.50) as occurred with Urabe-containing vaccines. This study demonstrates the power of active postmarketing surveillance to identify or exclude events too rare to be detected in prelicensure trials.

PMID:

17204517

[PubMed - indexed for MEDLINE]

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Publication Types, MeSH Terms, Substances

Publication Types

• Research Support, Non-U.S. Gov't

MeSH Terms

• England/epidemiology
• Humans
• Incidence
• Infant
• International Classification of Diseases
• Measles-Mumps-Rubella Vaccine/adverse effects*
• Measles-Mumps-Rubella Vaccine/supply & distribution
• Medical Record Linkage
• Medical Records Systems, Computerized
• Meningitis, Aseptic/diagnosis
• Meningitis, Aseptic/epidemiology*
• Meningitis, Aseptic/etiology*
• Mumps virus/classification
• Patient Admission/statistics & numerical data
• Population Surveillance
• Product Surveillance, Postmarketing
• Risk Factors
• Seizures/diagnosis
• Seizures/epidemiology*
• Seizures/etiology*
• Vaccination/adverse effects
• Vaccination/statistics & numerical data
• Wales/epidemiology

Substances

• Measles-Mumps-Rubella Vaccine

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Full Text Sources

• HighWire Press
• EBSCO
• Ingenta plc
• OhioLINK Electronic Journal Center
• Ovid Technologies, Inc.

Other Literature Sources

• Labome Researcher Resource - ExactAntigen/Labome

Medical

• Seizures - MedlinePlus Health Information

Miscellaneous

• Swets Information Services

http://www.ncbi.nlm.nih.gov/pubmed/17204517?dopt=AbstractPlus

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