Acute flaccid paralysis surveillance indicators in the Democratic Republic of Congo during 2008-2014

“Of the 13,749 AFP cases investigated, 58.9% received at least three doses of oral polio vaccine (OPV), 7.3% never received OPV, while the status of 18.3% was unknown.” Pan African Medical Journal 2016

Adverse events associated with childhood vaccines other than pertussis and rubella. Summary of a report from the Institute of Medicine.

The committee found that the evidence favored acceptance of a causal relation between diphtheria and tetanus toxoids and Guillain-Barré syndrome and brachial neuritis, between measles vaccine and anaphylaxis, between oral polio vaccine and Guillain-Barré syndrome, and between unconjugated Hib vaccine and susceptibility to Hib disease. The committee found that the evidence established causality between diphtheria and tetanus toxoids and anaphylaxis, between measles vaccine and death from measles vaccine-strain viral infection, between measles-mumps-rubella vaccine and thrombocytopenia and anaphylaxis, between oral polio vaccine and poliomyelitis and death from polio vaccine-strain viral infection, and between hepatitis B vaccine and anaphylaxis. JAMA 1994

‘An American tragedy’. the Cutter incident and its implications for the Salk polio vaccine in New Zealand 1955-1960.

“During the United States polio immunisation campaign in 1955 a number of children immunised with Cutter Laboratories vaccine were stricken with the disease, halting the programme.” Health History 1990

Aseptic meningitis after vaccination against measles and mumps

“This retrospective study (1979 to 1986) investigated the possible etiologic relationship between vaccination and aseptic meningitis in 115 hospitalized children who became ill within 30 days of vaccination with the Leningrad 3 strain of mumps virus and the Edmonston-Zagreb strain of measles virus.” The Pediatric Infectious Disease Journal 1989

Bordetella parapertussis outbreak in Southeastern Minnesota and the United States, 2014. (2017)

“All patients were vaccinated against pertussis, suggesting that pertussis vaccination is ineffective against B. parapertussis.” Medicine 2017

Canine rabies in Nigeria, 1970 – 1980 reported cases in vaccinated dogs.

“Of the 14 cases there were 10 cases of apparent vaccine failure involving modified live (low egg passage chick embryo) vaccine in use during the study period. In 4 of these cases, infection may actually have been induced by the vaccine.”  International Journal of Zoonoses 1982


Challenges in Interpretation of Diagnostic Test Results in a Mumps Outbreak in a Highly Vaccinated Population. 2017

“This is the first published report of an outbreak of mumps in Ontario in which all confirmed cases had been vaccinated against the disease.” Clinical and Vaccine Immunology 2017

Characteristics of poliovirus strains from long-term excretors with primary immunodeficiencies.

“ Long-term excretion of vaccine strains of poliovirus has been documented for many years and instances of paralytic poliomyelitis in hypogammaglobulinaemic patients who were subsequently found to have been excreting virus for prolonged periods have been reported in the U.S.A., Germany and Japan.” Developmental Biology 2001

Chronic progressive poliomyelitis secondary to vaccination of an immunodeficient child.

“We investigated an immunodeficient child in whom chronic progressive poliomyelitis developed after she had received live oral poliovirus vaccine. Poliovirus, Type II, was isolated from throat and stool during life and from several sites within the brain at autopsy.” The New England Journal of Medicine 1977

Comparison of neutralizing antibody titers against outbreak-associated measles genotypes (D4, H1 and B3) in Iran.

“Despite the accessibility of a promising vaccine, outbreaks of the measles virus (MV) take place even in well-vaccinated populations.” Pathogens and Disease 2016

Continuing measles transmission in students despite school-based outbreak control program.

“Forty-six cases occurred among students more than two weeks after control program implementation. All 46 had a school record indicating adequate measles vaccination; 13 had been vaccinated at control program clinics by one jet-injector team (Team A).” American Journal of Epidemiology 1985

Deep sequencing reveals persistence of cell-associated mumps vaccine virus in chronic encephalitis.

“Notwithstanding this, we describe here devastating neurological complications associated with the detection of live-attenuated mumps virus Jeryl Lynn (MuV(JL5)) in the brain of a child who had undergone successful allogeneic transplantation for severe combined immunodeficiency (SCID). This is the first confirmed report of MuV(JL5) associated with chronic encephalitis and highlights the need to exclude immunodeficient individuals from immunisation with live-attenuated vaccines.” Acta Neuropathologica 2017

Detection of fecal shedding of rotavirus vaccine in infants following their first dose of pentavalent rotavirus vaccine.

“Studies on rotavirus vaccine shedding and its potential transmission within households including immunocompromised individuals are needed to better define the potential risks and benefits of vaccination.” Vaccine 2011

Disseminated, persistent, and fatal infection due to the vaccine strain of varicella-zoster virus in an adult following stem cell transplantation.

“Here, we describe the fatality of an immunocompromised patient who received the varicella vaccine. His medical history provides a cautionary lens through which to view the decision of when vaccination is appropriate. A middle-aged man with non-Hodgkin lymphoma received chemotherapy and a stem cell transplant. He was vaccinated 4 years post-transplantation, despite diagnosis of a new low-grade lymphoma confined to the lymph nodes.” Clinical Infectious Diseases 2016

Efficacy of a Russian-backbone live attenuated influenza vaccine among children in Senegal: a randomised, double-blind, placebo-controlled trial.

“INTERPRETATION: Live attenuated influenza vaccine was well tolerated in young children in Senegal, but did not provide protection against influenza.” The Lancet Global Health 2016

An emergent poxvirus from humans and cattle in Rio de Janeiro State: Cantagalo virus may derive from Brazilian smallpox vaccine.

“Together, the data suggested that CTGV may have derived from VV-IOC by persisting in an indigenous animal(s), accumulating polymorphisms, and now emerging in cattle and milkers as CTGV. CTGV may represent the first case of long-term persistence of vaccinia in the New World. Virology 2000

Evidence for immunisation failure in vaccinated adult dogs infected with canine parvovirus type 2c

“An outbreak of canine parvovirus type 2c (CPV-2c) infection in vaccinated adult dogs is reported.” New Microbiologica 2008

Explosive school-based measles outbreak: intense exposure may have resulted in high risk, even among revaccinees.

“The authors studied inoculum intensities as measured by proxy variables and the contagiousness of properly vaccinated persons who contracted measles among 51 measles patients infected in one school, at home, or elsewhere, utilizing preexisting records of measles cases and 214 healthy controls from an explosive school outbreak that occurred in a rural Finnish municipality in 1989.” American Journal of Epidemiology 1998

Failed rubella immunization in adults: association with immunologic and virological abnormalities.

“Immunologic and virological studies were performed in 13 adults (12 women and one man) who failed to seroconvert (as shown by rubella hemagglutination-inhibition [HAI] techniques) after single or repeated courses of HPV-77 DE/5 or RA 27/3 rubella virus vaccine.” The Journal of Infectious Diseases 1985

The failure of an inactivated mink enteritis virus vaccine in four preparations to provide protection to dogs against challenge with canine parvovirus-2

“Four experimental vaccine preparations comprising a strain of mink enteritis virus inactivated by either formalin or beta-propiolactone, and either adjuvanted or nonadjuvanted, failed to stimulate a consistent serum antibody response in 20 vaccinated dogs and failed to protect all but one of these dogs against oral challenge with canine parvovirus-2.” Canadian Journal of Comparative Medicine 1982

Failure of inactivated influenza A vaccine to protect healthy children aged 6-24 months.

“Inactivated influenza vaccine did not reduce the attack rate of influenza A infection in 6-24 month old children.” Pediatrics International 2004

Failure to reach the goal of measles elimination. Apparent paradox of measles infections in immunized persons.

“RESULTS: We found 18 reports of measles outbreaks in very highly immunized school populations where 71% to 99.8% of students were immunized against measles.” Archives of Internal Medicine 1994

Fever and multisystem organ failure associated with 17D-204 yellow fever vaccination: a report of four cases.

“FINDINGS: The clinical presentations were characterised by fever, myalgia, headache, and confusion, followed by severe multisystemic illnesses. Three patients died. Vaccine-related variants of yellow fever virus were found in plasma and cerebrospinal fluid of one vaccinee. The convalescent serum samples of two vaccinees showed antibody responses of at least 1:10240. Immunohistochemical assay of liver tissue showed yellow fever antigen in the Kuppfer cells of the liver sample.” Lancet 2001

Finding the ‘who’ in whooping cough: vaccinated siblings are important pertussis sources in infants 6 months of age and under.

“At its peak, siblings were the most important sources of pertussis in infants 6 months and younger, particularly fully vaccinated children aged 2 and 3 years. Waning immunity before the booster at 4 years may leave this age group susceptible to infection.” Communicable Diseases Intelligence Quarterly Report 2014

Haemophilus influenzae type b meningitis in a vaccinated and immunocompetent child.

“We report a case of a fifteen-months-old girl, previously healthy and vaccinated, admitted in the emergency room with fever and vomiting. She was irritable and the Brudzinski’s sign was positive.” Journal of Infection and Public Health 2017

Haemophilus influenzae Type b Meningitis in the Short Period after Vaccination: A Reminder of the Phenomenon of Apparent Vaccine Failure.

“We present two cases of bacterial meningitis caused by Haemophilus influenzae type b (Hib) which developed a few days after conjugate Hib vaccination. This phenomenon of postimmunization provocative time period is reviewed and discussed. These cases serve as a reminder to clinicians of the risk, albeit rare, of invasive Hib disease in the short period after successful immunization.” Case Reports in Infectious Diseases 2012

Hepatitis B Vaccines—to Switch or Not to Switch

“Shortly after the licensure of Heptavax-B in 1981 and its general availability in July 1982, the discovery of the acquired immunodeficiency syndrome (AIDS) among male homosexuals threatened the success of this product, since some of the hepatitis B surface antigen (HBsAg)-positive plasma donors were members of this high-risk group. Intensive epidemiologic, virological, and serological evaluations were launched, which eventually found no evidence for the transmission of AIDS to recipients of the plasma-derived HBsAg vaccine.” JAMA 1987

Herpes zoster due to Oka vaccine strain of varicella zoster virus in an immunosuppressed child post cord blood transplant.

“A 5-year-old boy was vaccinated with the Oka strain of varicella zoster virus vaccine before cord blood transplant for chronic granulomatous disease in 2005. In 2006, he developed herpes zoster on his left arm. DNA from the vesicular rash confirmed the Oka vaccine strain of varicella zoster virus caused this complication. He responded well to 10 days of aciclovir treatment.”
Journal of Paediatrics and Child Health 2007

Herpes zoster in an adult recipient of live attenuated varicella vaccine.

“A healthy 30-y-old female physician who was immunized with two doses of live attenuated varicella vaccine developed a localized case of zoster involving the right T8-10 dermatomes 36 mo after vaccination. The virus isolated from her rash was an unusual wild-type of varicella-zoster virus. After immunization she developed detectable antibodies to varicella-zoster virus, but antibodies were no longer detectable after 20 mo.” The Journal of Infectious Diseases 1989

High diversity of poliovirus strains isolated from the central nervous system from patients with vaccine-associated paralytic poliomyelitis.

“To establish the etiology of vaccine-associated paralytic poliomyelitis (VAPP), isolates from the central nervous system (CNS) from eight patients with VAPP were compared with stool isolates from the same patients.” Journal of Virology 1994

High rate of vaccine failure after administration of acellular pertussis vaccine pre- and post-liver transplantation in children at a children’s hospital in Japan.

“We assessed the serological response to pertussis vaccines administered pre- and post-liver transplantation in 58 pediatric patients at a children’s hospital in Japan.” Transplant Infectious Disease 2016

Horizontal transmission of a human rotavirus vaccine strain–a randomized, placebo-controlled study in twins

“Transmission of excreted vaccine-derived infectious virus from vaccinated to unvaccinated individuals is possible within close contacts.” Vaccine 2011

Horizontal transmission of the Leningrad-Zagreb mumps vaccine strain: a report of six symptomatic cases of parotitis and one case of meningitis.

“Here we report horizontal symptomatic transmission of the Leningrad-Zagreb (L-Zagreb) mumps vaccine virus. Children who were the source of transmission had been vaccinated with the MMR vaccine (Serum Institute of India) contained L-Zagreb mumps virus. This is the first report of horizontal symptomatic transmission of this vaccine. The etiology of all seven contact cases was confirmed by epidemiological linking, serology and by F, SH, NP and HN mumps virus genes sequencing.” Vaccine 2012

Immune persistence after pertussis vaccination.

“An increased prevalence of pertussis in older populations has been found, mainly caused by waning immunity after vaccination.” Human Vaccines & Immunotherapeutics 2017

Interference of Vaccine Derived Polio Viruses with Diagnosis of Enteroviral Diseases in Neonatal Period.

“OPV vaccinated neonates commonly pass the vaccine virus in their pharynx and stool which can be mistaken with NPEV.” Journal of Clinical and Diagnostic Research 2016

Invasive pneumococcal disease: From a tertiary care hospital in the post-vaccine era

“A breakthrough infection occurring with 13-valent pneumococcal conjugate vaccine (PCV13) in Turkey are previously described.” Human Vaccines & Immunotherapeutics 2017

A large vaccine-derived poliovirus outbreak on Madura Island–Indonesia, 2005.

“Between June and October 2005, 45 laboratory-confirmed type 1 vaccine-derived poliovirus (VDPV) cases were identified on Madura Island in Indonesia. Genetic sequencing data on VDPV isolates were consistent with replication and circulation for up to approximately 2 years. Concurrent circulation with type 1 wild poliovirus (WPV) enabled comparisons of VDPV and WPV cases and found that clinical and epidemiological features of both were similar. Attack rates for VDPV were as high as those for WPV. Of 41 VDPV case patients with known vaccination status, 25 (61%) had received zero oral polio vaccine (OPV) doses.” The Journal of Infectious Diseases 2008

Late vitamin K deficiency bleeding after intramuscular prophylaxis at birth: a case report

“We report the case of a 6-week-old female who presented an intracranial hemorrhage due to late vitamin K deficiency bleeding (VKDB).” Journal of Perinatology 2009


“Regretfully, the story of polio vaccine was not without tragedy. In April 1955, soon after mass polio vaccination began in the United States, reports trickled in to the Surgeon General concerning atypical cases of paralytic polio. Several paralytic polio cases were reported in California in patients who had received the polio vaccine about a week earlier but the paralysis only affected the arm or leg in which they received the injection. Each of these cases occurred in polio vaccine produced by Cutter pharmaceutical company. The Surgeon General immediately pulled all Cutter polio vaccine, but it was too late; nearly 400,000 children had been inoculated with Cutter polio vaccine and 250 cases of atypical paralytic polio occurred. There were also reports of the Wyeth pharmaceutical company polio vaccine causing paralysis and death in several children in the northeastern United States.” Clinical and Translational Science 2010

Live attenuated varicella vaccine: evidence that the virus is attenuated and the importance of skin lesions in transmission of varicella-zoster virus. National Institute of Allergy and Infectious Diseases Varicella Vaccine Collaborative Study Group.

“To examine whether the live varicella vaccine virus is attenuated, we analyzed varicella vaccine-induced contact cases of clinical chickenpox in healthy siblings of immunized children with leukemia. A rash developed approximately 1 month later in 156 children with leukemia who had been vaccinated. Vaccine-type virus was isolated from 25 of these children.” Journal of Pediatrics 1990

Local public health response to vaccine-associated measles: case report.

“A five-year-old Canadian-born boy with a history of a hematopoetic stem cell transplant three years previously received live attenuated measles, mumps, and rubella (MMR) vaccine. Over the subsequent 7 to 14 days, he developed an illness clinically consistent with measles. There was no travel history or other measles exposure. Serology and polymerase chain reaction (PCR) testing confirmed acute measles infection.” BMC Public Health 2013

Low vaccine efficacy of mumps component among MMR vaccine recipients in Chennai, India

“These facts inevitably state that MMR vaccine failed to offer protection in vaccinated individuals against mumps infection.” Indian Journal of Medical Research 2014

A limited measles outbreak in a highly vaccinated US boarding school

“OBJECTIVES: We investigated a measles outbreak that began in March 2003 in a Pennsylvania boarding school with >600 students to identify all cases, including the source; implement outbreak control measures; and evaluate vaccine effectiveness.” Pediatrics 2005

Live, attenuated varicella zoster vaccination of an immunocompromised patient.

“ vaccine for the prevention of herpes zoster outbreaks in adults over the age of 60 years has recently been approved. A 76-year-old white female with a history of recurrent left axillary breast cancer undergoing chemotherapy was given a Zostavax injection by her primary care physician.” Journal of General Internal Medicine 2008

Major measles epidemic in the region of Quebec despite a 99% vaccine coverage

“Vaccination coverage for the total population was 99.0%. Incomplete vaccination coverage is not a valid explanation for the Quebec City measles outbreak.” Journal Public Health 1991

Measles outbreak in a fully immunized secondary-school population.

“An outbreak of measles occurred among adolescents in Corpus Christi, Texas, in the spring of 1985, even though vaccination requirements for school attendance had been thoroughly enforced.” The New England Journal of Medicine 1987

A measles outbreak in a middle school with high vaccination coverage and evidence of prior immunity among cases, Beijing, P.R. China.

“CONCLUSIONS: This is the first report from China showing measles transmission among persons with prior evidence of immunity.” Vaccine 2017

Mechanism of Injury-Provoked Poliomyelitis

“Skeletal muscle injury is known to predispose its sufferers to neurological complications of concurrent poliovirus infections. This phenomenon, labeled “provocation poliomyelitis,” continues to cause numerous cases of childhood paralysis due to the administration of unnecessary injections to children in areas where poliovirus is endemic.”  Journal of Virology 1998

Modified chickenpox in children immunized with the Oka/Merck varicella vaccine.

“The severity of chickenpox in healthy children who have received Oka/Merck varicella vaccine since 1981 is described.” Pediatrics 1993

Molecular typing of canine parvovirus strains circulating from 2008 to 2012 in an organized kennel in India reveals the possibility of vaccination failure

“The CPV {Canine parvovirus} vaccines used in the present study failed to generate protective antibody titer against heterogeneous CPV antigenic types. The findings were confirmed when the affected pups were treated with hyper-immune heterogeneous purified immunoglobulin’s against CPV in dogs of different antigenic types. Infection, Genetics and Evolution 2014

MRI findings in an infant with vaccine-associated paralytic poliomyelitis.

“We report a Brazilian infant who developed VAPP 40 days after receiving the first dose of oral polio vaccine (OPV). MR images of the cervical and thoracic spinal cord showed lesions involving the anterior horn cell, with increased signal intensity on T2-weighted sequences. We would like to emphasize the importance of considering VAPP as a differential diagnosis in patients with acute flaccid paralysis and an MRI showing involvement of medulla oblongata or spinal cord, particularly in countries where OPV is extensively administered.” Pediatric Radiology 2010

Mumps epidemic in vaccinated children in West Switzerland

“Since 1991, 6 years after the recommendation of universal childhood vaccination against measles, mumps, and rubella (MMR triple vaccine), Switzerland is confronted with a large number of mumps cases affecting both vaccinated and unvaccinated children. Up to 80% of the children suffering from mumps between 1991 and 1995 had previously been vaccinated, the majority with the Rubini vaccine strain.” Schweizerische Medizinische Wochenschrift 1997

Mumps vaccine virus transmission

“In this work we report the mumps vaccine virus shedding based on the laboratory confirmed cases of the mumps virus (MuV) infection. The likely epidemiological sources of the transmitted mumps virus were children who were recently vaccinated with the mumps vaccine containing Leningrad-Zagreb or Leningrad-3 MuV. The etiology of the described cases of the horizontal transmission of both mumps vaccine viruses was confirmed by PCR with the sequential restriction analysis.” Voprosy Virusologii 2013

Neonatal paralytic poliomyelitis. A case report.

“We report a child who became symptomatic with apnea at 18 days of age and who subsequently developed a permanent monoparesis. Serologic and cultural evidence indicated the virus as poliovirus vaccine type. Another infant who received live oral poliovirus vaccine was probably the source of the infecting virus.” Archives of Neurology 1986

Neurologic complications in oral polio vaccine recipients.

“A vaccine-like strain of poliovirus was isolated from each patient, and each had symptoms (left leg paralysis in three; developmental regression, spasticity, and progressive fatal cerebral atrophy in one) persisting for at least 6 months.” Journal of Pediatrics 1986

Outbreak of aseptic meningitis associated with mass vaccination with a urabe-containing measles-mumps-rubella vaccine: implications for immunization programs.

“A mass immunization campaign with a Urabe-containing measles-mumps-rubella vaccine was carried out in 1997 in the city of Salvador, northeastern Brazil, with a target population of children aged 1-11 years. There was an outbreak of aseptic meningitis following the mass campaign.” American Journal of Epidemiology 2000

Outbreak of measles among persons with prior evidence of immunity, New York City, 2011

“BACKGROUND: Measles was eliminated in the United States through high vaccination coverage and a public health system able to rapidly respond to measles. Measles may occur among vaccinated individuals, but secondary transmission from such individuals has not been documented.” Clinical Infectious Diseases 2014

Outbreak of pertussis in highly immunized adolescents and its secondary spread to their families.

“An outbreak of pertussis was recognized in a highly immunized sixth-grade class of schoolchildren. Among 43 children aged 11-12 years in the class, 38 had been immunized with three doses or more of DTP containing whole-cell pertussis vaccine, two with two doses of DTP and three children were unimmunized.” Acta Paediatrica Japonica 1995

Outbreak of poliomyelitis in Hispaniola associated with circulating type 1 vaccine-derived poliovirus.

“An outbreak of paralytic poliomyelitis occurred in the Dominican Republic (13 confirmed cases) and Haiti (8 confirmed cases, including 2 fatal cases) during 2000-2001. All but one of the patients were either unvaccinated or incompletely vaccinated children, and cases occurred in communities with very low (7 to 40%) rates of coverage with oral poliovirus vaccine (OPV). The outbreak was associated with the circulation of a derivative of the type 1 OPV strain, probably originating from a single OPV dose given in 1998-1999. The vaccine-derived poliovirus associated with the outbreak had biological properties indistinguishable from those of wild poliovirus.” Science 2002

An outbreak of varicella in elementary school children with two-dose varicella vaccine recipients–Arkansas, 2006.

BACKGROUND: In June 2006, the Advisory Committee on Immunization Practices (ACIP) expanded its June 2005 recommendation for a second dose of varicella vaccine during outbreaks to a recommendation for routine school entry second dose varicella vaccination. In October 2006, the Arkansas Department of Health was notified of a varicella outbreak among students where some received a second dose during an outbreak-related vaccination campaign in February 2006.” The Pediatric Infectious Disease Journal 2009

Paralytic poliomyelitis associated with the Sabin 3 revertant strain of poliovirus in Bahrain

“We report a case of vaccine-associated paralytic poliomyelitis (VAPP) in Bahrain. The case occurred in an 8-week-old infant who had received a dose of oral polio vaccine (OPV) 7 days after birth. She was in contact with two vaccinees who had received OPV during the national immunisation campaign conducted 10 days before her birth.” Annals of Tropical Paediatrics 2011

Pertussis epidemic despite high levels of vaccination coverage with acellular pertussis vaccine. 2015

“Despite high levels of vaccination coverage, pertussis circulation cannot be controlled at all. The results question the efficacy of the present immunization programmes.” Enfermedades Infecciosas y Microbiología Clínica 2015

Pertussis outbreak in US elementary school with high vaccination coverage

“BACKGROUND: An outbreak of pertussis in a US elementary school with high vaccination coverage was investigated to evaluate vaccine effectiveness and to identify potential contributing factors.” The Pediatric Infectious Disease Journal 2001

Pneumococcal vaccine failure: can it be a primary immunodeficiency?

“We present the case of a 4-year-old boy, with complete antipneumococcal vaccination, who had necrotising pneumonia with pleural effusion and severe pancytopaenia with need for transfusion. A vaccine-serotype Streptococcus pneumoniae was isolated in the blood culture. On follow-up, detailed medical history, laboratory and genetic investigation led to the diagnosis of X linked dyskeratosis congenita.” BMJ Case Reports 2014

A Pneumonia Case Associated with Type 2 Polio Vaccine Strains

“A 3-month-old male infant with no underlying diseases was admitted to Beijing Haidian Hospital on July 31, 2015, where he was diagnosed with lobular pneumonia exactly 26 days after he had received his second dose of trivalent OPV (tOPV). The infant was born from a second regular pregnancy by normal delivery (35/36 weeks gestation, birth weight: 3550 g). The infant also received two birth dose vaccinations (the Bacillus Calmette–Guerin vaccine and hepatitis B vaccine), and no adverse reactions to the vaccinations were reported. The infant had no signs of immunodeficiency. His family had no history of travel in the months before he became ill.” Chinese Medical Journal 2017;year=2017;volume=130;issue=1;spage=111;epage=112;aulast=Li

Polio programme: let us declare victory and move on.

“In 2011, there were an extra 47,500 new cases of NPAFP. Clinically indistinguishable from polio paralysis but twice as deadly, the incidence of NPAFP was directly proportional to doses of oral polio received. Though this data was collected within the polio surveillance system, it was not investigated.” Indian Journal of Medical Ethics 2012

Poliovirus Infections in Four Unvaccinated Children — Minnesota, August–October 2005

“On September 29, 2005, the Minnesota Department of Health (MDH) identified poliovirus type 1 in an unvaccinated, immunocompromised infant girl aged 7 months (the index patient) in an Amish community whose members predominantly were unvaccinated for polio. The patient has no paralysis; the source of the patient’s infection is unknown. Subsequently, poliovirus infections in three other children within the index patient’s community have been documented.” CDC 2005

Post-licensure safety surveillance for Prevenar 13(®) in France

“RESULTS: In 4 years and 4 months, 376 AEs, including 252 severe (67%), were recorded, 83 of which occurred following an injection of Prevenar 13(®) alone: 39 cutaneous AEs, 16 neurological AEs, four cases of collapse or shock, nine cases of fever, and one of thrombocytopenia. For the serious AEs, the outcome was favorable in 88% of cases and none of the 12 reported deaths were attributed to a side effect of vaccination. Fifty-nine cases of pneumococcal disease that suggest an ineffective vaccine were reported, but only 16 can be considered as a real failure of the vaccination.” Archives De Pediatrie 2017

Post-vaccinal distemper encephalitis in two Border Collie cross littermates

“CASE HISTORY: One 4.5-month-old male Border Collie cross presented with aggression and seizures in October 2006. A 16-month-old, female, spayed Border Collie cross presented with hypersalivation and a dropped jaw and rapidly became stuporous in September 2007. The dogs were littermates and developed acute neurological signs 5 and 27 days, respectively, after vaccination with different modified live vaccines containing canine distemper virus.” New Zealand Veterinary Journal 2015

Post-vaccine measles in a child with concomitant influenza, Sicily, Italy, March 2015

“We describe the occurrence of measles in an 18 month-old patient in Sicily, Italy, in March 2015, who received the first dose of a measles-containing vaccine seven days before onset of prodromal symptoms.” Euro Surveillance 2015

A prefecture-wide survey of mumps meningitis associated with measles, mumps and rubella vaccine.

“A survey of untoward reactions, especially central nervous system reactions, after the administration of a newly introduced measles, mumps and rubella (MMR) vaccine in Gunma Prefecture, Japan, was initiated soon after 4 patients were hospitalized for aseptic meningitis. Thirty-five, 6 and 2 children developed meningitis, convulsive disorders and parotitis, respectively, within 2 months after MMR vaccination during the 8-month period extending from April to November, 1989.” The Pediatric Infectious Disease Journal 1991

Questions regarding the safety and duration of immunity following live yellow fever vaccination.

“We found that antiviral immunity may be lost in 1-in-3 to 1-in-5 individuals within 5 to 10 years after a single vaccination and that children may be at greater risk for primary vaccine failure. The safety profile of YFV-17D was compared to other licensed vaccines including oral polio vaccine (OPV) and the rotavirus vaccine, RotaShield, which have subsequently been withdrawn from the US and world market, respectively. Expert commentary: Based on these results and recent epidemiological data on vaccine failures (particularly evident at >10 years after vaccination), we believe that current recommendations to no longer administer YFV-17D booster vaccination be carefully re-evaluated, and that further development of safer vaccine approaches should be considered.” Expert Review of Vaccines 2014

[Recurrent meningitis and inherited complement deficiency].

“The first patient had four attacks of meningococcal meningitis and an episode of pneumonia of unknown aetiology in childhood. The second had six attacks of meningitis. He also suffered from recurrent infections (otitis media, tonsillitis, chronic mucopurulent rhinitis and subsequent pansinusitis complicated by nasal polyposis) since childhood. No autoimmune disease was documented in either patient. They both received meningococcal and pneumococcal vaccines.” Epidemiologie, Mikrobiologie, Imunologie 2016

Reemergence of vaccinia virus during Zoonotic outbreak, Pará State, Brazil.

“In 2010, vaccinia virus caused an outbreak of bovine vaccinia that affected dairy cattle and rural workers in Pará State, Brazil. Genetic analyses identified the virus as distinct from BeAn58058 vaccinia virus (identified in 1960s) and from smallpox vaccine virus strains. These findings suggest spread of autochthonous group 1 vaccinia virus in this region.” Emerging Infectious Diseases journal 2013

A report of outbreaks of measles on the southern coast of Iran from 2009 to 2015. (2017)

“A high percentage of cases with measles in rural areas were reported in the areas which were covered by complete vaccination.” Electronic Physician Journal 2017

Review of accidents caused by incomplete inactivation of viruses.

“Recent molecular evidence has now shown that formaldehyde-inactivated Venezuelan equine encephalitis vaccines were the probable cause of the outbreaks of the disease during the 1969-1972 pandemic in Central America. In the author’s opinion it is remarkable that formaldehyde is still used for the preparation of inactivated vaccines, particularly since it is known that the procedure also affects the immunogenic epitopes of the viruses.” Developments in Biological Standardization 1993

Risk factors for measles vaccine failure among immunized students.

“An outbreak of measles occurred in a municipal school system which had reported 98% of students immunized against measles. A case-control study was conducted to determine reasons for vaccine failure. Vaccine failure was associated with immunizations that could not be documented in the provider’s records.” Pediatrics 1985

Risks of reintroduction of polio after eradication: the vaccine origin of an outbreak of type 3 poliomyelitis.

Possible causes of the origin and progress of the outbreak included the pattern of virus excretion from vaccinees, mutations identified in epidemic viruses and the unique vaccination policies in Poland during the years preceding the epidemic.Developments in Biologicals (Basel) 2001

Rotavirus shedding in premature infants following first immunization

“CONCLUSIONS: The findings of this study demonstrate that premature infants have positive stools by EIA, viral culture, and RT-PCR at varying time points during 2 weeks following first-dose immunization with RV5. RT-PCR shedding rates need to be clinically evaluated in the context of virus quantification by cell culture, which was low. No symptomatic transmission to HHC {household contacts} was detected in this study, supporting low transmissibility of vaccine virus shed by these infants born prematurely.” Vaccine 2011

Rotavirus vaccine-derived shedding and viral reassortants

“ Although nearly half of these reassortant-associated cases had underlying medical conditions, such as severe combined immunodeficiency disorder, further study is needed to understand the relationship between shedding, viral reassortants and underlying medical conditions.” Expert Review Vaccines 2012

Rotavirus vaccines: viral shedding and risk of transmission.

“ A review of rotavirus vaccine prelicensure studies shows that viral shedding and transmission were higher with the old tetravalent rhesus rotavirus vaccine than with the current human attenuated monovalent rotavirus vaccine and the pentavalent bovine-human reassortant vaccine.” The Lancet Infectious Diseases 2008

Safety of live vaccinations on immunosuppressive therapy in patients with immune-mediated inflammatory diseases, solid organ transplantation or after bone-marrow transplantation – A systematic review of randomized trials, observational studies and case reports.

“However, some serious vaccine-related adverse events occurred. 32 participants developed an infection with the vaccine strain; in most cases the infection was mild. However, in two patients fatal infections were reported” Vaccine 2017

Secondary measles vaccine failures identified by measurement of IgG avidity: high occurrence among teenagers vaccinated at a young age.

“Failure to seroconvert (primary vaccine failure) is believed to be the principal reason (approx. > 95%) why some vaccinees remain susceptible to measles and is often attributed to the persistence of maternal antibodies in children vaccinated at a young age. Avidity testing is able to separate primary from secondary vaccine failures (waning and/or incomplete immunity), but has not been utilized in measles epidemiology.” Epidemiology and Infection 2000

Secondary transmission of varicella vaccine virus in a chronic care facility for children.

“A 16-year-old varicella-seronegative resident at a chronic care facility received varicella vaccine; 15 days later he developed severe varicella. Subsequently, a 13-year-old resident and a 39-year-old health care worker developed mild varicella. We demonstrate that vaccine-strain virus was transmitted to both persons, and that transmission included at least 2 variant vaccine strains.” Journal of Pediatrics 2006

Serotype-specific mucosal immune response and subsequent poliovirus replication in vaccinated children

“In the case of poliovirus Type 3, about 10% of children were still excreting the vaccine virus 9 weeks after administering the third dose.” Journal of Medical Virology 2003

Severe combined immunodeficiency (SCID) and rotavirus vaccination: reports to the Vaccine Adverse Events Reporting System (VAERS).

“Stool rotavirus testing was positive in all cases and the virus was identified as the vaccine strain in six cases. Prolonged viral shedding was documented in five cases.” Vaccine 2010

Severe tetanus in immunized patients with high anti-tetanus titers

“Severe (grade III) tetanus occurred in three immunized patients who had high serum levels of anti-tetanus antibody. The disease was fatal in one patient. One patient had been hyperimmunized to produce commercial tetanus immune globulin. Two patients had received immunizations 1 year before presentation.”
American Academy of Neurology 1992

Sibling transmission of vaccine-derived rotavirus (RotaTeq) associated with rotavirus gastroenteritis.

“Although rotavirus vaccines are known to be shed in stools, transmission of vaccine-derived virus to unvaccinated contacts resulting in symptomatic rotavirus gastroenteritis has not been reported to our knowledge. We document here the occurrence of vaccine-derived rotavirus (RotaTeq [Merck and Co, Whitehouse Station, NJ]) transmission from a vaccinated infant to an older, unvaccinated sibling, resulting in symptomatic rotavirus gastroenteritis that required emergency department care.” Pediatrics 2010

Some ethical issues arising from polio eradication programmes in India.

We argue that given the current risks/benefits profile of this vaccine, there is an urgent need to review the programme and take remedial action to address existing problems (at least in India). The second issue we discuss is the fact that there is little effort to gain the informed consent of the parents of vaccinated children, as they are not currently told about the potential limitations of OPV or the possibility of vaccine-induced harm.Bioethics 2005

Specific T cell frequency and cytokine expression profile do not correlate with protection against tuberculosis after bacillus Calmette-Guérin vaccination of newborns

“CONCLUSIONS: The frequency and cytokine profile of mycobacteria-specific T cells did not correlate with protection against TB {tuberculosis}. Critical components of immunity against Mycobacterium tuberculosis, such as CD4 T cell IFN-γ production, may not necessarily translate into immune correlates of protection against TB disease.” American Journal of Respiratory and Critical Care Medicine 2010

Surveillance of suspected poliomyelitis in Albania, 1980-1995: suggestion of increased risk of vaccine associated poliomyelitis.

“Poliovirus was isolated from six subjects who were defined as contact vaccine-associated cases. Characterization of isolates by both antigenic and molecular methods showed that, in all cases, the disease was associated with type 2 or 3 polioviruses of vaccine origin with retromutations known to be associated with loss of Sabin attenuated phenotype. Infection occurred despite the fact that all patients had records of previous immunization with oral polio vaccine (OPV), suggesting a failure of vaccination.” Vaccine 1989

The total influenza vaccine failure of 1947 revisited: major intrasubtypic antigenic change can explain failure of vaccine in a post-World War II epidemic.

“These findings are important, because complete lack of cross-immunogenicity has been found previously only with antigenic shift, in which antigenically novel antigens have been captured by reassortment of human and animal strains, sometimes leading to pandemics.” Proceedings of the National Academy of Sciences 2002

Transmission of imported vaccine-derived poliovirus in an undervaccinated community in Minnesota.

CONCLUSIONS: This is the first demonstrated transmission of VDPV in an undervaccinated community in a developed country. Continued vigilance is needed in all countries to identify poliovirus infections in communities at high risk of poliovirus transmission.” The Journal of Infectious Diseases 2009

Transmission of measles among a highly vaccinated school population–Anchorage, Alaska, 1998.

“During August 10-November 23, 1998, 33 confirmed measles cases were reported to the Anchorage Department of Health and Human Services and the Alaska Department of Health and Social Services (ADHSS). Of these, 26 cases were confirmed by positive rubeola IgM antibody test, and seven met the clinical case definition. This was the largest outbreak of measles in the United States since 1996. This report summarizes results of the epidemiologic investigation conducted by ADHSS and underscores the importance of second-dose requirements for measles vaccine.” CDC 1999

Transmission of the L-Zagreb mumps vaccine virus, Croatia, 2005-2008.

“We report on three cases of symptomatic transmission of the L-Zagreb mumps vaccine virus from three vaccinated children to five adult contacts. The five contact cases were parents of the vaccinated children and presented with parotitis and in one case also with aseptic meningitis. The etiology of the contacts’ illness was determined by viral culture, genomic sequencing, serology and epidemiological linking. Two of the vaccinated children developed vaccine associated parotitis as an adverse event three weeks following immunization.” Euro Surveillance 2008

Tuberculosis II: the failure of the BCG vaccine.

“Despite the questioning of its innocuousness and efficacy, the BCG {bacille Calmette-Guerin} vaccine was imposed worldwide in 1950 by medical and political organizations that showed no concern for these questions.” Medical Hypotheses 1999

Tuberculosis in Newborns: The Lessons of the “Lübeck Disaster” (1929-1933). Fox GJ, et al. PLoS Pathog. 2016.

“In an accident later known as the Lübeck disaster, 251 neonates were orally given three doses of the new Bacille Calmette-Guérin (BCG) antituberculosis (TB) vaccine contaminated with Mycobacterium tuberculosis. A total of 173 infants developed clinical or radiological signs of TB but survived the infection, while 72 died from TB.” PLoS Pathogens 2016

Two successive outbreaks of mumps in Nova Scotia among vaccinated adolescents and young adults.

METHODS: Two recent outbreaks in Nova Scotia were investigated by public health officials. Cases were defined by laboratory confirmation of infection (i.e., isolation of mumps virus by culture) or clinical diagnosis in people epidemiologically linked to a laboratory-confirmed case.” Canadian Medical Association Journal 2006

Unexpectedly limited durability of immunity following acellular pertussis vaccination in preadolescents in a North American outbreak.

“CONCLUSIONS: Our data suggests that the current schedule of acellular pertussis vaccine doses is insufficient to prevent outbreaks of pertussis.” Clinical Infectious Diseases 2012

Update on Vaccine-Derived Polioviruses – Worldwide, January 2014-March 2015.

“Circulating VDPVs (cVDPVs) resemble WPVs and, in areas with low OPV coverage, can cause polio outbreaks. Immunodeficiency-associated VDPVs (iVDPVs) can replicate and be excreted for years in some persons with PIDs.” Morbidity and Mortality Weekly Report 2015

Use of a novel real-time PCR assay to detect oral polio vaccine shedding and reversion in stool and sewage samples after a mexican national immunization day.

“During replication, oral polio vaccine (OPV) can revert to neurovirulence and cause paralytic poliomyelitis. In individual vaccinees, it can acquire specific revertant point mutations, leading to vaccine-associated paralytic poliomyelitis (VAPP). With longer replication, OPV can mutate into vaccine-derived poliovirus (VDPV), which causes poliomyelitis outbreaks similar to those caused by wild poliovirus. After wild poliovirus eradication, safely phasing out vaccination will likely require global use of inactivated polio vaccine (IPV) until cessation of OPV circulation.” Journal of Clinical Microbiology 2011

[Vaccination failure: case report of Haemophilus influenzae b meningitis in a 14-month-old child].

“We described the case of a 14-months-old child showing a bacterial purulent meningitis with Hib, despite of a well driven vaccination.” Pathologie-biologie 2005

Vaccination to Alzheimer Disease. Is it a Promising Tool or a Blind Way?

“Unfortunately, the promising vaccines like the AN 1792 were halted during clinical trials because of adverse effects like meningoencephalitis.” Current Medicinal Chemistry 2016


“An 8-month-old girld develoepd paralytic poliomyelitis. Twenty-nine days prior to the onset of paralysis she had been in contact with a sibling recently immunized with trivalent oral polio vaccine.!” Pediatrics 1971

Vaccine-associated poliomyelitis in an infant with agammaglobulinemia

“We describe a female infant with agammaglobulinemia who contracted vaccine-associated poliomyelitis. Poliovirus type 2 was isolated from the initial stool specimen.” Acta Paediatrica Scandinavica 1980

Vaccine-derived poliomyelitis and postpolio syndrome: an Italian Cutter Incident

“Post-polio syndrome is a condition characterized by increased muscle weakness, atrophy, fatigue and pain developing several years after the acute polio event. We describe a 52-year-old patient who experienced post-polio syndrome; he had contracted acute paralytic poliomyelitis at 12 months of age, shortly after the third dose of Salk polio vaccine.” JRSM Open 2014

Vaccine Failures in Patients Properly Vaccinated with 13-Valent Pneumococcal Conjugate Vaccine in Catalonia, a Region with Low Vaccination Coverage.

“Vaccine failures occurring with 13-valent pneumococcal conjugate vaccine (PCV13) in 3 pediatric hospitals in Barcelona (2012-2013) are described. PCV13 vaccine failure was defined as the occurrence of an invasive pneumococcal infection in children properly vaccinated by PCV13. Among 84 patients with invasive pneumococcal infection, 32 had received at least one dose of PCV13. Seventeen of them had invasive pneumococcal infection produced by a PCV13 serotype. Among those, 9 patients were considered to have a PCV13 vaccine failure. Serotype 3 was isolated in 6 patients, serotype 19A in 2 and serotype 6B in 1.” The Pediatric Infectious Disease Journal 2016

Vaccine-induced polioencephalomyelitis in Scotland.

“A six-month-old British female, living in Glasgow was admitted in June 1986 with a four-day history of fever and lower limb weakness following immunisation with oral polio and triple (DTP) vaccines. Examination revealed paralysis of all limbs, facial muscles and right diaphragm, scoliosis, opsoclonus and ocular flutter. Poliovirus types 1, 2 and 3, isolated from her stool specimens were all vaccine-like strains.” Scottish Medical Journal 1988

Vaccine-related adverse events in Cuban children, 1999-2008.

“The DTwP vaccine exhibited the highest rate of adverse events. Common minor events were: fever (17,538), reactions at injection site (4470) and systemic side effects (2422). Rare events (by WHO definition) reported were: persistent crying (2666), hypotonic-hyporesponsive episodes (3), encephalopathy (2) and febrile seizures (112). Severe events included: anaphylaxis (2), respiratory distress (1), multiple organ failure (1), sudden death (1), vaccine-associated paralytic poliomyelitis (2), toxic shock syndrome (3), and sepsis (1). The 10 deaths and 3 cases of disability were investigated by an expert commission, which concluded that 8 of the 13 severe events were vaccination-related.” MEDICC Review 2012

Vaccine-related mumps infections in Thailand and the identification of a novel mutation in the mumps fusion protein

“An outbreak of nine cases of mumps was reported from a total of 97 vaccinated nursing students at two medical colleges in Thailand in 2010, 16-26 days after administration of MMR vaccine containing the L-Zagreb mumps strain.” Biologicals 2013

Variability in Humoral Immunity to Measles Vaccine: New Developments.

“Despite the existence of an effective measles vaccine, resurgence in measles cases in the USA and across Europe has occurred, including in individuals vaccinated with two doses of the vaccine.” Trends in Molecular Medicine 2015

Varicella outbreak in a highly-vaccinated school population in Beijing, China during the voluntary two-dose era. (2017)

BACKGROUND: Two-dose varicella vaccination has been available in Beijing since 2012 in the private sector. We investigated a varicella outbreak in a highly vaccinated elementary school population.” Vaccine 2017

Varicella vaccination after fingolimod: A case report.

A 36 year old woman with relapsing remitting multiple sclerosis and a childhood history of varicella (chickenpox) received 5 days of fingolimod (Gilenya(®)) before the drug was stopped upon discovery that she was varicella zoster virus (VZV) seronegative.” Multiple Sclerosis and Related Disorders 2013

Vitamin K deficiency bleeding in an infant despite adequate prophylaxis

Vitamin K deficiency in infants can cause life-threatening haemorrhages. To prevent this, neonates in the Netherlands receive an oral dose of 1 mg vitamin K directly after birth. In addition, because breast milk contains little vitamin K, breast-fed infants receive a daily dose of 25 micrograms the first three months.” Nederlands Tijdschrift Voor Geneeskunde 2003

What, in Fact, Is the Evidence That Vaccinating Healthcare Workers against Seasonal Influenza Protects Their Patients? A Critical Review

Conclusion. The arguments for uniform healthcare worker influenza vaccination are not supported by existing literature. The decision whether to get vaccinated should, except possibly in extreme situations, be that of the individual healthcare worker, without legal, institutional, or peer coercion.” International Journal of Family Medicine 2012

What is the cause of a rash after measles-mumps-rubella vaccination?

“We describe a 17-month-old child with fever and rash after measles-mumps-rubella vaccination. Detection of vaccine-strainmeasles virus in his urine by polymerase chain reaction confirmed the diagnosis of a vaccine reaction rather than wild-type measles. We propose that measles virus should be sought and identified as vaccine or wild-type virus when the relationship between vaccination and measles-like illness is uncertain.” The Medical Journal of Australia 1999

Why Do Pertussis Vaccines Fail?

“During the 2010 pertussis epidemic in California, there was considerable concern in the press and in public health communications about the possible contribution of vaccine failures to the problem.1,2 In this commentary, I examine why pertussis vaccines fail…” Pediatrics 1999