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Severe Upper Extremity Dysfunction After 4CMenB Vaccination in a Young Infant
Tobias Tenenbaum1, Johanna Niessen, Horst Schroten
1From the *Paediatric Infectious Diseases, University Children`s Hospital Mannheim, Heidelberg University, Mannheim, Germany; and †Department of Clinical Radiology and Nuclear Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Insights
The 4-component meningococcal serogroup B vaccine (4CMenB) may cause prolonged upper extremity dysfunction in infants. This case highlights the need for clear injection site recommendations when administering 4CMenB with routine vaccines.
Area of Science:
- Pediatrics
- Immunology
- Vaccinology
Background:
- The 4-component meningococcal serogroup B vaccine (4CMenB), also known as Bexsero, is the first vaccine available against serogroup B meningococcus.
- 4CMenB has received approval in Europe, Canada, and Australia, indicating its potential inclusion in national immunization programs.
Abstract:
The 4-component meningococcal serogroup B vaccine 4CMenB (Bexsero) is the first vaccine against this serogroup and has been approved by licensing authorities in Europe, Canada and Australia. Therefore, the vaccine may enter soon nationwide vaccine recommendation schemes. We report on a case of a 5-month-old infant who developed prolonged upper extremity dysfunction after the second injection of the 4CMenB vaccine in the left deltoid muscle and was concomitantly applied with 2 routine vaccinations. Myositis, periostitis, (peri-) vasculitis and axillary inflammation were confirmed by magnetic resonance imaging. Two months after initial initiation of an anti-inflammatory and an antibiotic treatment, symptoms completely resolved. Administration of 3 vaccines requires clear recommendations for the preferred injection site in infants because increased reactogenicity of 4CMenB may lead to local severe adverse events.
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