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Risks of convulsion and aseptic meningitis following measles-mumps-rubella vaccination in the United Kingdom

E Miller1, N Andrews, J Stowe

  • 1Immunisation Department, Centre for Infections, Health Protection Agency, 61 Colindale Avenue, London, UK. liz.miller@hpa.org.uk

American Journal of Epidemiology
|January 6, 2007
PubMed

Insights

The Priorix measles-mumps-rubella (MMR) vaccine, used after 1998, showed no increased risk of mumps meningitis in England and Wales. Active surveillance confirmed its safety profile, differing from earlier Urabe strain vaccines.

Area of Science:

  • Immunization and Vaccine Safety
  • Public Health Surveillance
  • Pediatric Infectious Diseases

Background:

  • Urabe strain measles-mumps-rubella (MMR) vaccines were withdrawn in the UK in 1992 due to aseptic meningitis risk.
  • A replacement MMR vaccine, Priorix, was introduced in 1998, necessitating safety evaluation.
  • Post-marketing surveillance is crucial for detecting rare adverse events following vaccination.

Purpose of the Study:

  • To evaluate the risk of aseptic meningitis and convulsions associated with the Priorix MMR vaccine.
  • To compare the safety profile of Priorix with previously used Urabe strain MMR vaccines.
  • To demonstrate the effectiveness of active surveillance in identifying rare vaccine-related events.

Main Methods:

  • Active surveillance of aseptic meningitis and convulsions in children aged 12-23 months post-Priorix vaccination.
  • Analysis of laboratory-confirmed mumps meningitis cases.
  • Review of a regional hospital-admitted case database for aseptic meningitis.
  • Calculation of risk estimates and confidence intervals for adverse events.

Main Results:

  • No laboratory-confirmed mumps meningitis cases were detected after 1.6 million doses of Priorix.
  • The upper 95% confidence limit for mumps meningitis risk with Priorix was significantly lower than with Urabe vaccines.
  • No aseptic meningitis cases were detected in a hospital database after over 99,000 doses of Priorix.
  • An elevated risk of convulsions was observed 6-11 days post-Priorix, consistent with the measles component, but not 15-35 days post-vaccination.

Conclusions:

  • The Priorix MMR vaccine is not associated with an increased risk of mumps meningitis.
  • The safety profile regarding aseptic meningitis is favorable compared to Urabe strain vaccines.
  • Active post-marketing surveillance effectively identified rare adverse events, confirming vaccine safety.

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