Tag: side effects

Vaccines and Seizures

A newborn baby getting an EEG.
A newborn baby getting an EEG.

Can vaccines cause seizures?

Unfortunately, they sometimes can.

Vaccines and Febrile Seizures

The CDC reports that “There is a small increased risk for febrile seizures after MMR and MMRV vaccines.”

We also know that:

  • there is a small increased risk for febrile seizures when the influenza vaccine is given at the same time as either the Prevnar13 vaccine or the DTaP vaccine, although “the risk of febrile seizure with any combination of these vaccines is small and CDC’s Advisory Committee on Immunization Practices (ACIP) does not recommend getting any of these vaccines on separate days.”
  • there is a small increased risk for febrile seizures if the combined MMR and chicken pox vaccine (ProQuad) is given to infants between the ages of 12 to 23 months vs their getting the shots separately.

But remember that febrile seizures, while scary for parents and other caregivers, are rarely dangerous.

It is also important to note that while febrile seizures are common, they are not commonly triggered by vaccines. A 2016 report in Pediatrics, “Vaccines and Febrile Seizures: Quantifying the Risk,” states that “The risk is 1 febrile seizure per pediatric practice every 5 to 10 years.”

Not surprisingly though, vaccines can likely prevent many febrile seizures, as chicken pox, flu, Hib, measles, mumps, rubella, pneumococcal infections and other vaccine-preventable diseases often cause fever and can trigger febrile seizures themselves.

Also, a study recently found that children who got sick with pertussis could be at increased risk for developing epilepsy, or recurrent seizures. That’s just another good reason to get vaccinated and protected against vaccine-preventable diseases.

Vaccines and Other Types of Seizures

While vaccines can sometimes trigger febrile seizures, they do not typically cause other types of seizures.

It was once thought that seizures were a common side effect of the DPT vaccine, but many studies have found that to not be true and seizures following DPT was even removed as a table injury from the NVICP. In fact, many of these children were instead found to have Dravet syndrome, which put them at increased risk for febrile seizures.

Long-term non-febrile seizures are still listed as side effects for the DTaP and MMR vaccine, but they “are so rare it is hard to tell if they are caused by the vaccine.”

A 2010 study in Pediatrics, “Lack of Association Between Acellular Pertussis Vaccine and Seizures in Early Childhood,” did not find any “increased risk for seizures after
DTaP vaccination among children who were aged 6 weeks to 23 months.”

Do report any reaction to VAERS if you think it was caused by a vaccine though.

Seizures After Getting Vaccines

If vaccines don’t usually cause seizures, then how do you explain a healthy infant developing seizures a few days, weeks, or months after getting his vaccines?

We’re always looking for reasons why something happened. The example I use is from my wife, who is a pediatrician. She was about to vaccinate a four-month-old baby, and while she was drawing the vaccine from the syringe, the baby had a seizure — and went onto have a permanent seizure disorder. Now, my wife hadn’t given the vaccine yet. But if she had given that vaccine five minutes earlier, there would have been no amount of statistical data in the world that would have convinced that mother that the vaccine hadn’t caused the baby’s seizure. You can do studies that show no increased risk with vaccines and seizure disorders, but that mother might still say “well, that’s true for the population but it’s not true for my child.”

Temporal associations are powerful, and they’re hard to defeat with statistics or studies.

Paul Offit, MD interview for The Thinking Persons Guide to Autism

There are many seizure disorders that begin in infancy.

Some even start in the newborn period, before a baby is a month old.

They are not triggered by vaccines though.

They include:

  • Infantile Spasms (first described in 1841) – typically begin when infants are about 4 months old, just when they get their second set of vaccines, which weren’t available when Dr. West described his own son’s repeated spasms
  • Benign Familial Neonatal Seizures – often genetic, seizures may begin on a baby’s third day of life
  • Benign Neonatal Convulsions – begin on the fifth day of life – the “fifth day fits,” and the seizures stop in about a month

If your child got her first hepatitis B vaccine when she was five days old and began having seizures, would you accept a diagnosis of Benign Neonatal Convulsions or would you blame the shot?

Would you remember the saying about correlation and causation?

For More Information on Vaccines and Seizures:

Table Injuries and Vaccine Court

Vaccine injuries, while rare, are certainly real.

In fact, as most people are aware, since 1988, almost $3.5 billion dollars have been paid out by the Vaccine Court for 4,899 compensated awards under the National Vaccine Injury Compensation Program.

While most were settled and “cannot be characterized as a decision by HHS or by the Court that the vaccine caused an injury,” some of the claims were either compensated by a court decision or by concession and for which “it is more likely than not that the vaccine caused the injury or the evidence supports fulfillment of the criteria of the Vaccine Injury Table.”

History of the Vaccine Injury Table

The Vaccine Injury Table was created by the National Childhood Vaccine Injury Act of 1986 and includes “a table of vaccines, the injuries, disabilities, illnesses, conditions, and deaths resulting from the administration of such vaccines, and the time period in which the first symptom or manifestation of onset or of the significant aggravation of such injuries, disabilities, illnesses, conditions, and deaths is to occur after vaccine administration for purposes of receiving compensation under the Program.”

The Vaccine Injury Table:

  • “is a listing of covered vaccines and associated injuries,” although some covered vaccines, like Hib, hepatitis A, chicken pox, flu, HPV, Prevnar, and the meningococcal vaccines, are not on the table
  • “makes it easier for some people to get compensation,” since if a symptom of a table injury occurs within the time frame of getting a table vaccine, then unless another cause is found, “it is presumed that the vaccine was the cause of the injury”
  • “lists and explains injuries and/or conditions that are presumed to be caused by vaccines,” from anaphylaxis and encephalopathy to thrombocytopenic purpura
  • has been modified several times, most notably in 1995 (HHE and seizures from DTP were removed as table injuries and chronic arthritis from rubella was added), 1997 (thrombocytopenia (measles), brachial neuritis (tetanus), and anaphylaxis (hepatitis B) were added as table injuries), and 2002 (intussusception (rotavirus) added as a table injury).
  • is typically only modified if an Institute of Medicine report finds scientific evidence that a condition could be caused by a vaccine with guidance of the Advisory Commission on Childhood Vaccines

Some people, especially anti-vaccine folks who think it is too hard to get compensated under the NVICP, will be surprised that one of the main overarching guiding principles for making changes to the Vaccine Injury Table is that:

Where there is credible scientific and medical evidence both to support and to reject a proposed change (addition or deletion) to the Table, the change should, whenever possible, be made to the benefit of petitioners.

Guiding Principles for Recommending Changes to the Vaccine Injury Table

Changes to the Vaccine Injury Table were proposed last year.

Off Table Injuries

As you can imagine, since most new vaccines do not have table injuries, the VICP has shifted from Vaccine Injury Table to off-Table claims.

While that may change if last years proposed changes are adopted, off-Table claims can still be compensated, a vaccine is not just presumed as causing an injury in these cases.

For More Information on Table Injuries

 

Those Times Other Countries Impulsively Banned Vaccines

Many people know that other countries have different immunization requirements and recommendations than the United States.

In fact, it is even a popular anti-vaccine myth that we give many more vaccines than most other countries. There actually isn’t all that many differences.

What is very different is how quickly most other countries are to pull vaccines at the first sign of an issue, even when it is isn’t likely to be caused by the vaccine and when the consequences are that people are going to be put at risk of life-threatening vaccine preventable diseases.

We saw this when:

  • France suspended the routine vaccination of teens against hepatitis B because of the possible association of the vaccine with multiple sclerosis in 1998 amid “pressure from anti-vaccine groups and reports in the French media have raised concerns about a link between HBV immunisation and new cases or relapses of MS and other demyelinating diseases,” even though “scientific data available do not support a causal association between HBV immunisation and central nervous system diseases, including MS.”
  • DTP vaccination was interrupted in Sweden, Japan, UK, The Russian Federation, Ireland, Italy, the former West Germany, and Australia leading to a pertussis incidence that “was 10 to 100 times lower in countries where high vaccine coverage was maintained than in countries where immunisation programs were compromised by anti-vaccine movements.” The United States was one of the countries that did not stop using DTP at the time, at least not until we had the newer, DTaP vaccine. In Japan, where they switched from DTP to DT in 1974 and raised the ages that children be vaccinated, only 10% had been been vaccinated against pertussis by 1976. In 1979, there was a large pertussis outbreak with 41 deaths.
  • Japan switched from the combination MMR to single vaccines in 1993 because their MMR vaccine had been linked to aseptic meningitis.
  • Some reports say that Sweden and Finland suspended the use of the Pandemrix swine flu vaccine because of its association with narcolepsy, but since the vaccine was for the 2009-10 swine flu pandemic, that seems academic.
  • Japan suspended both Hib and Prevnar for a month in 2011 “because of seven deaths of children that were ultimately found to be unrelated to the vaccines.”
  • Japan also quickly began investigating the HPV vaccines shortly after they became available in Japan “because of fears of complex regional pain syndrome.”
  • Italy temporarily suspended the Fluad flu vaccine after 19 deaths in 2014, but quickly reinstated it after the vaccine was found to be safe.
  • Italy, Germany, Switzerland, Canada, and Australia temporarily suspended the Agrippal and Fluad flu vaccines in 2012 because “white particles were seen in syringes carrying the vaccines,” even though they were said to be a normal part of the manufacturing process.

What are the consequences of frequently suspending and banning vaccines? It certainly doesn’t improve people’s confidence in vaccines or help keep immunization rates up. And we know what it does to disease rates.

Of course, that is not to say that the United States will never stop or suspend the use of a vaccine. The RotaShield rotavirus vaccine is a good example. It was taken off the market just nine months after being approved because it was associated with intussusception.

And we aren’t using FluMist this flu season.

But in most other situations, vaccines were investigated and found to be safe, all without having to be suspended, leaving kids unprotected and at risk of getting a vaccine-preventable disease.

Other countries have sometimes found issues with their vaccines too. Western Australia temporarily suspended FluVax flu shots for children under age 5 years because of an increased rate of fever and febrile seizures in 2010.

Mexico suspended vaccinations after at least two kids died and 29 got sick in Chiapas in 2015 (bacterial contamination of vaccine vials). But it wasn’t all vaccines in the whole country as many reported. It was only a few lots in that part of the country, and vaccines were quickly restarted once they were found to be safe.

It should also be noted that many of these vaccines were never used in the United States, including the brand of MMR that was used in Japan and the Pandemrix swine flu vaccine.

Even FluVax was not used in the United States for young children. In 2010, Afluria, which is essentially the same vaccine, was only recommended for children who were at least 9-years-old.

For More Information:

 

References:
Akehurst C. France suspends hepatitis B immunisation for adolescents in schools. Euro Surveill. 1998;2(41):pii=1143
Gangarosa EJ. Impact of anti-vaccine movements on pertussis control: the untold story. Lancet. 1998 Jan 31;351(9099):356-61.

Jonas Salk

Dr. Jonas Salk developed the first polio vaccine in 1955, just before Albert Sabin developed his oral polio vaccine in 1961.

Approval of Salk’s vaccine followed national testing of the Polio Pioneers, one million children between the ages of six to nine years. Salk also gave his experimental vaccine to his children, his wife, and of course, to himself.

In 1955, he appeared on See It Now and told Edward R. Murrow:

Who owns the patent on this vaccine?
Well, the people, I would say. There is no patent. Could you patent the sun?

Although he could not have patented his vaccine if he had wanted to, he was right that “there is no patent.” The National Foundation for Infantile Paralysis, which he was working for, didn’t patent the vaccine either.

In 1961, Sabin’s live, attenuated polio vaccine replaced Jonas Salk’s inactivated polio vaccine that had been in use since 1955. The United States switched back to IPV in 2000 because of concerns over VAPP.

In addition to his vaccine, his Salk Institute for Biological Studies continues to do research on aging and regenerative medicine, cancer biology, immune system biology, metabolism and diabetes, neuroscience and neurological disorders and plant biology.

For More Information On Jonas Salk:

IOM Vaccine Reports

The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public.

“With the start of the new school year, it’s time to ensure that children are up to date on their immunizations, making this report’s findings about the safety of these eight vaccines particularly timely,” said committee chair Ellen Wright Clayton, professor of pediatrics and law, and director, Center for Biomedical Ethics and Society, Vanderbilt University, Nashville, Tenn.  “The findings should be reassuring to parents that few health problems are clearly connected to immunizations, and these effects occur relatively rarely.  And repeated study has made clear that some health problems are not caused by vaccines.”

They occasionally issue reports and safety reviews about vaccines:

Reading these reports will help you to understand why vaccine experts argue that vaccines do not cause autism, SIDS, or multiple sclerosis, etc.

For More Information On IOM Vaccine Reports:

Fainting After Vaccines

Have you heard about children getting dizzy or fainting (syncope) after getting a vaccine?

Although we usually hear about it after teens getting their vaccines, the “CDC has received reports of people fainting after nearly all vaccines.”

Fortunately, fainting after getting a vaccine does not cause any lasting effects, although getting hurt from a fall could. That’s why “experts recommend having patients sit in a chair or lay down when they receive a vaccination.  In addition, patients should be observed for 15 minutes after vaccination.”

A common vaccine side effect, it isn’t clear though if it is the vaccine or the pain from the shot that leads to the fainting. Teens commonly faint after other painful procedures too, such as getting a blood draw or donating blood.

For more information:

 

Latex Allergies and Vaccines

Can you get vaccines if you have a latex allergy?

“Dry, natural rubber is used in the tip of syringe plungers, the tip on prefilled syringes, vial stoppers,” and could cause a problem for some people with latex allergies.

According to the CDC:

If a person reports a severe (anaphylactic) allergy to latex, vaccines supplied in vials or syringes that contain natural rubber latex should not be administered unless the benefit of vaccination clearly outweighs the risk for a potential allergic reaction. In these cases, providers should be prepared to treat patients who are having an allergic reaction.

For latex allergies other than anaphylactic allergies (e.g., a history of contact allergy to latex gloves), vaccines supplied in vials or syringes that contain dry, natural rubber or natural rubber latex may be administered.

Many vaccines use synthetic rubber or synthetic latex though, so getting vaccinated with one of these vaccines would be a good alternative if your child has a severe allergy to latex.

Keep in mind that you aren’t supposed to simply remove the latex stopper from a vaccine vial to try and avoid triggering an anaphylactic reaction. That did work for one patient in the case report “Anaphylaxis after hepatitis B vaccination.” She got her second dose using “rubber free technique” and didn’t have a reaction.

Still, latex allergies with vaccines doesn’t seem to be a big problem.

One study “Vaccination of persons allergic to latex: a review of safety data in the Vaccine Adverse Event Reporting System (VAERS),” in the journal Vaccine “revealed only 28 cases of possible immediate-type hypersensitivity reactions in vaccine recipients with a history of allergy to latex.” And only two of those required hospitalization.

For more information: