Disseminated BCG infection and rotavirus enteritis in an infant with severe immunodeficiency: a causal association study
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View abstract on PubMed
Summary
This summary is machine-generated.Live attenuated vaccines can cause fatal complications in infants with undiagnosed severe combined immunodeficiency (SCID). This case highlights the need for newborn screening and pre-vaccination assessments to identify high-risk infants for tailored immunization strategies.
Area Of Science
- Immunology
- Vaccinology
- Pediatrics
Background
- Live attenuated vaccines pose risks for infants with undiagnosed severe combined immunodeficiency (SCID).
- Disseminated Bacillus Calmette-Guérin (BCG) infection and rotavirus enteritis are potential fatal complications.
Purpose Of The Study
- To evaluate vaccine-adverse event causality in a fatal case of SCID.
- To discuss implications for immunization policy regarding live attenuated vaccines.
Main Methods
- Retrospective review of clinical records, microbiological and immunological tests, and genetic analysis.
- Causality assessment using WHO-UMC and revised WHO classification for adverse events following immunization.
- Genetic analysis identified a TNFRSF13B variant, confirming SCID.
Main Results
- An infant with SCID developed disseminated BCG infection and rotavirus enteritis after vaccination.
- Both complications were deemed vaccine-associated in the context of undiagnosed SCID.
- The infant died at 13 months despite intensive treatment and hematopoietic stem cell transplantation.
Conclusions
- Live vaccines administered to neonates with unrecognized SCID can lead to fatal complications.
- Integrating newborn screening for SCID with pre-vaccination assessment is crucial for identifying high-risk infants.
- Risk-stratified immunization strategies, including tuberculosis surveillance, should be considered for vulnerable populations.
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