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Neurologic complications of immunizations
Insights
Pertussis immunization is effective and safe for most children, despite concerns about neurologic complications. Current data is inconclusive regarding increased risks for children with pre-existing neurologic conditions.
Area of Science:
- Pediatric Neurology
- Immunology
- Public Health
Background:
- Concerns exist regarding potential neurologic complications following pertussis immunization.
- Anecdotal reports and retrospective studies have fueled debate about vaccine safety, particularly for children with pre-existing neurologic conditions.
Purpose of the Study:
- To evaluate the conclusive evidence linking pertussis immunization to serious acute neurologic illness.
- To assess the risk of complications in children with stable pre-existing neurologic disease or a family history of neurologic disease after pertussis vaccination.
Main Methods:
- Review of existing literature on pertussis vaccine complications.
- Analysis of anecdotal reports and retrospective studies.
- Identification of gaps in statistical data regarding vaccine-related encephalopathy.
Main Results:
- Data suggesting increased risk for children with stable pre-existing neurologic disease is inconclusive.
- There is a lack of firm statistical data on the incidence of pertussis vaccine-related encephalopathy.
- The current literature relies heavily on anecdotal reports and retrospective studies with questionable conclusions.
Conclusions:
- Pertussis remains a dangerous disease, and pertussis immunization is effective in preventing it.
- There is no conclusive proof of a higher incidence of complications in children with seizure disorders or stable neurologic abnormalities.
- Pertussis vaccination is recommended for all children except those with specific contraindications like allergic hypersensitivity or progressive neurologic disorders.
Abstract:
Although there does appear to be at least a temporal relationship between pertussis immunization and serious acute neurologic illness, data to suggest that children with stable preexisting neurologic disease or positive family history of neurologic disease are at increased risk for complications of pertussis immunizations are inconclusive. Furthermore, there are no firm statistical data concerning the incidence of pertussis vaccine-related encephalopathy. Rather, the literature on pertussis vaccine complications is replete with anecdotal reports and retrospective studies with a number of questionable conclusions drawn from this inadequate data base. Unfortunately, these conclusions have been sensationalized and exploited with litigious fervor to the point that the practice of pertussis immunization is being questioned in the United States. A number of points should be reiterated: pertussis is a dangerous and deadly disease, as seen in the epidemic in Great Britain; pertussis immunization is effective in protecting against the disease; and there is no conclusive proof that the incidence of complications from pertussis vaccination of children with seizure disorders or other preexisting stable neurologic abnormalities is higher, because appropriate studies have not been done to define such a risk. We would do well to keep these facts in mind in order to avoid a disaster similar to the pertussis epidemic in Great Britain. Pertussis vaccination should be given to all children except those with allergic hypersensitivity, a progressive neurologic disorder, or an adverse reaction to a previous pertussis dose.