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1. Vasculitis as an adverse event following immunization – Systematic literature review

Author

Bonetto C, Trotta F, Felicetti P, Gs, Alarcón, Santuccio C, Ns, Bachtiar, Brauchli Pernus Y, Chandler R, Girolomoni G, Rd, Hadden, Kucuku M, Ozen S, Pahud B, Top K, Varricchio F, Rp, Wise, Zanoni G, Živković S, Jan Bonhoeffer, and Brighton Collaboration Vasculitis Working Group

Subjects
Vasculitis, medicine.medical_specialty, Case definition, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, medicine, Humans, 030212 general & internal medicine, Intensive care medicine, Adverse effect, Vasculitis,Vaccine,Immunization,Case definition,Systematic review,Adverse event following immunization (AEFI), 030203 arthritis & rheumatology, General Veterinary, General Immunology and Microbiology, business.industry, Adverse event following immunization (AEFI), Public Health, Environmental and Occupational Health, medicine.disease, Vaccination, Infectious Diseases, IgA vasculitis, Systematic review, Molecular Medicine, Immunization, Kawasaki disease, Observational study, business, Vaccine
Abstract

Background Several types of vasculitis have been observed and reported in temporal association with the administration of various vaccines. A systematic review of current evidence is lacking. Objective This systematic literature review aimed to assess available evidence and current reporting practice of vasculitides as adverse events following immunization (AEFI). Methods We reviewed the literature from 1st January 1994 to 30th June 2014. This review comprises randomized controlled trials, observational studies, case series, case reports, reviews and comments regardless of vaccine and target population. Results The initial search resulted in the identification of 6656 articles. Of these, 157 articles were assessed for eligibility and 75 studies were considered for analysis, including 6 retrospective/observational studies, 2 randomized controlled trials, 7 reviews, 11 case series, 46 case reports and 3 comments. Most of the larger, higher quality studies found no causal association between vaccination and subsequent development of vasculitis, including several studies on Kawasaki disease and Henoch-Schonlein purpura (IgA vasculitis). Smaller case series reported a few cases of vasculitis following BCG and vaccines against influenza and hepatitis. Only 24% of the articles reported using a case definition of vasculitis. Conclusions Existing literature does not allow establishing a causative link between vaccination and vasculitides. Further investigations were strengthened by the use of standardized case definitions and methods for data collection, analysis and presentation to improve data comparability and interpretation of vasculitis cases following immunization.

Published
2016
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2. Risk of Guillain-Barré syndrome after 2010–2011 influenza vaccination

Author

Galeotti F, Massari M, Beghi E, Chiò A, Logroscino G, Filippini G, Benedetti MD, Pugliatti M, Santuccio C, Raschetti R, The ITANG study Group [Clinical research assistants: Sara Marconi, Giorgia Giussani, Enrica Bersano, Umberto Manera, Stefano Zoccolella, Antonio Leo, Roberta Barki, Marco Turatti, Stefania Leoni, Steering committee of the study: Ettore Beghi, Maria Donata Benedetti, Andrea Calvo, Adriano Chiò, Roberto D’Alessandro, Fernanda Ferrazin, Graziella Filippini, Giancarlo Logroscino, Giampiero Mazzaglia, Maura Pugliatti, Roberto Raschetti, Carmela Santuccio, Loriana Tartaglia, Francesco Trotta, Clinical centers, co investigators: E. Romagna: Roberto MICHELUCCI, Patrizia RIGUZZI, Tommaso SACQUEGNA, Anna Maria BORGHI, Vittoria MUSSUTO, Patrizia DE MASSIS, Rita Rinaldi, Walter NERI, Carlo GUIDI, Maria Rosaria TOLA, Enrico GRANIERI, Valentina SIMIONI, Paolo NICHELLI, Jessica MANDRIOLI, Donata GUIDETTI, Emilio TERLIZZI, Mario Giovanni TERZANO, Giovanni PAVESI, Fabrizio RASI, Claudio CALLEGARINI, Norina MARCELLO, Massimo BONDAVALLI, Alessandro RAVASIO, Marco CURRÒ DOSSI, Annamaria MAURO, Chiara MINARDI, Gabriele GRECO, Stefano AMIDEI, Enrico MONTANARI, Doriana MEDICI, Lombardy: Tommaso RICCARDI, Elisabetta D’ADDA, Luigi BETTONI, Luciano ABRUZZI, Elio AGOSTONI, Francesco BASSO, Andrea MAGNONI, Vittorio CRESPI, Maria REPACI, Antonella CHELDI, Mariagrazia BELLOTTI, Carlo FERRARESE, Natale Augusto CURTÒ, Giovanni MEOLA, Giuseppe ROTONDO, Eduardo NOBILE ORAZIO, Fabrizia TERENGHI, Franco SASANELLI, Alessio GALBUSSERA, Marco MATTIOLI, Marco TIRITICCO, Caterina NASCIMBENE, Alessandra VANOTTI, Stefano JANN, Luisa DE TONI FRANCESCHINI, Vincenzo SILANI, Nicola TICOZZI, Giancarlo COMI, Raffaella FAZIO, Patrizia PERRONE, Andrea GIORGETTI, Alessandro ROMORINI, Pietro BASSI, Domenico SANTORO, Nereo BRESOLIN, Simone TONIETTI, Massimo SUARDELLI, Giacomo BEZZI, Daria BALDINI, Angelo Maurizio CLERICI, Giuseppina CAFASSO, Daniele PORAZZI, Isidoro LA SPINA, Giampiero GRAMPA, Davide ZARCONE, Michele PERINI, Marco POLONI, Emanuela AGAZZI, Massimiliano FILOSTO, Alessandro PADOVANI, Renato BESANA, Edoardo DONATI, Eugenio MAGNI, Marco ARNABOLDI, Vincenzo BELCASTRO, Mario GUIDOTTI, Raffaella CLERICI, Maurizio RIVA, Eugenio VITELLI, Paolo PREVIDI, Giuseppe MICIELI, Elisa CANDELORO, Carlo DALLOCCHIO, Carla ARBASINO, Piedmont: Andrea CALVO: Scdu Neurologia 4—AOU S. Giovanni Battista, Cristina MOGLIA: Scdu Neurologia 4—AOU S. Giovanni Battista, Marco VERCELLINO, Bruno FERRERO, Pietro PIGNATTA, Enrico ODDENINO, Daniele IMPERIALE, Daniela LEOTTA, Maurizio GIONCO, Carlo RAVETTI, Roberto CAVALLO, Nicoletta Di Vito, Claudio GEDA, Simona BORTOLOTTO, Emilio LUDA DI CORTEMIGLIA, Giovanna LIOTTA, Emilio URSINO, Mario PALERMO, Luca AMBROGIO, Piero MEINERI, Michele DOTTA, Paolo GHIGLIONE, Joseph MAISTRELLI, Susana ONORATO, Maurizio LEONE, Diego Maria PAPURELLO, Angelo VILLANI, Roberto CONTI, Franco COPPO, Fabiana TESSER, Lucia Testa, Silvia Isabella Cattaneo, Maria Teresa Penza, Graziano Gusmaroli, Katia Savio, Franco Perla, Fabrizio Pisano, Fabio Poglio, Luca Pradotto, Valle d’Aosta: Edo Fausto BOTTACCHI, Puglia: Paolo LIVREA, Francesco FEDERICO, Maria TROJANO, Vito COVELLI, Bruno MAGGIO, Vito SANTAMATO, Bruno PASSARELLA, Giovanni ZIMATORE, Giorgio TRIANNI, Gerardo CIARDO, Salvatore INTERNO’, Veneto: Corrado MARCHINI, Sandro ZAMBITO MARSALA, Giorgio MICHIELI, Carlo BORSATO, Giuseppe DIDONÈ, Emma FRASSON, Alberto POLO, Vincenza ARGENTIERO, Vincenzo ROMEO, Novenia PERLOTTO, Roberto L’ERARIO, Gianfranco MICAGLIO, Tiziana ROSSO, Sandro BRUNO, Bruno GIOMETTO, Mirco SERENA, Rocco QUATRALE, Ernesto GASTALDO, Francesco PERINI, Michele DILEONE, Alessandro CASANO, Lauretta SILVESTRI, Alessandro BURLINA, Virginia MUNERATI, Sebastiano D’Anna, Flavio SANSON, Valeria SARTORI, Giuseppe MORETTO, Giovanna SQUINTANI, Salvatore MONACO, Maria Donata BENEDETTI, Simone FUSINA, Claudio BIANCONI, Fabiana PIMAZZONI, Angela BONOMETTI, Giampietro ZANETTE, Marco TURATTI, Sardinia: Stefania LEONI, Giuseppe MURA, Anna TICCA, Piernicola MARCHI, Davide MANCA], D'ALESSANDRO, ROBERTO, CIRIGNOTTA, FABIO, Galeotti F, Massari M, D'Alessandro R, Beghi E, Chiò A, Logroscino G, Filippini G, Benedetti MD, Pugliatti M, Santuccio C, Raschetti R, The ITANG study Group [Clinical research assistants: Sara Marconi, Giorgia Giussani, Enrica Bersano and Umberto Manera, Stefano Zoccolella and Antonio Leo, Roberta Barki, Marco Turatti, Stefania Leoni, Steering committee of the study: Ettore Beghi, Maria Donata Benedetti, Andrea Calvo and Adriano Chiò, Roberto D’Alessandro, Fernanda Ferrazin, Graziella Filippini, Giancarlo Logroscino, Giampiero Mazzaglia, Maura Pugliatti, Roberto Raschetti, Carmela Santuccio, Loriana Tartaglia and Francesco Trotta, Clinical centers and co-investigators: E. Romagna: Roberto MICHELUCCI, Patrizia RIGUZZI, Tommaso SACQUEGNA, Anna Maria BORGHI, Vittoria MUSSUTO, Patrizia DE MASSIS, Fabio CIRIGNOTTA, Rita Rinaldi, Walter NERI, Carlo GUIDI, Maria Rosaria TOLA, Enrico GRANIERI, Valentina SIMIONI, Paolo NICHELLI, Jessica MANDRIOLI, Donata GUIDETTI, Emilio TERLIZZI, Mario Giovanni TERZANO, Giovanni PAVESI, Fabrizio RASI, Claudio CALLEGARINI, Norina MARCELLO, Massimo BONDAVALLI, Alessandro RAVASIO, Marco CURRÒ DOSSI, Annamaria MAURO, Chiara MINARDI, Gabriele GRECO, Stefano AMIDEI, Enrico MONTANARI, Doriana MEDICI, Lombardy: Tommaso RICCARDI, Elisabetta D’ADDA, Luigi BETTONI, Luciano ABRUZZI, Elio AGOSTONI, Francesco BASSO, Andrea MAGNONI, Vittorio CRESPI, Maria REPACI, Antonella CHELDI, Mariagrazia BELLOTTI, Carlo FERRARESE, Natale Augusto CURTÒ, Giovanni MEOLA, Giuseppe ROTONDO, Eduardo NOBILE-ORAZIO, Fabrizia TERENGHI, Franco SASANELLI, Alessio GALBUSSERA, Marco MATTIOLI, Marco TIRITICCO, Caterina NASCIMBENE, Alessandra VANOTTI, Stefano JANN, Luisa DE TONI FRANCESCHINI, Vincenzo SILANI, Nicola TICOZZI, Giancarlo COMI, Raffaella FAZIO, Patrizia PERRONE, Andrea GIORGETTI, Alessandro ROMORINI, Pietro BASSI, Domenico SANTORO, Nereo BRESOLIN, Simone TONIETTI, Massimo SUARDELLI, Giacomo BEZZI, Daria BALDINI, Angelo Maurizio CLERICI, Giuseppina CAFASSO, Daniele PORAZZI, Isidoro LA SPINA, Giampiero GRAMPA, Davide ZARCONE, Michele PERINI, Marco POLONI, Emanuela AGAZZI, Massimiliano FILOSTO, Alessandro PADOVANI, Renato BESANA, Edoardo DONATI, Eugenio MAGNI, Marco ARNABOLDI, Vincenzo BELCASTRO, Mario GUIDOTTI, Raffaella CLERICI, Maurizio RIVA, Eugenio VITELLI, Paolo PREVIDI, Giuseppe MICIELI, Elisa CANDELORO, Carlo DALLOCCHIO, Carla ARBASINO, Piedmont: Andrea CALVO: Scdu Neurologia 4—AOU S. Giovanni Battista, Cristina MOGLIA: Scdu Neurologia 4—AOU S. Giovanni Battista, Marco VERCELLINO, Bruno FERRERO, Pietro PIGNATTA, Enrico ODDENINO, Daniele IMPERIALE, Daniela LEOTTA, Maurizio GIONCO, Carlo RAVETTI, Roberto CAVALLO, Nicoletta Di Vito, Claudio GEDA, Simona BORTOLOTTO, Emilio LUDA DI CORTEMIGLIA, Giovanna LIOTTA, Emilio URSINO, Mario PALERMO, Luca AMBROGIO, Piero MEINERI, Michele DOTTA, Paolo GHIGLIONE, Joseph MAISTRELLI, Susana ONORATO, Maurizio LEONE, Diego Maria PAPURELLO, Angelo VILLANI, Roberto CONTI, Franco COPPO, Fabiana TESSER, Lucia Testa, Silvia Isabella Cattaneo, Maria Teresa Penza, Graziano Gusmaroli, Katia Savio, Franco Perla, Fabrizio Pisano, Fabio Poglio, Luca Pradotto, Valle d’Aosta: Edo Fausto BOTTACCHI, Puglia: Paolo LIVREA, Francesco FEDERICO, Maria TROJANO, Vito COVELLI, Bruno MAGGIO, Vito SANTAMATO, Bruno PASSARELLA, Giovanni ZIMATORE, Giorgio TRIANNI, Gerardo CIARDO, Salvatore INTERNO’, Veneto: Corrado MARCHINI, Sandro ZAMBITO MARSALA, Giorgio MICHIELI, Carlo BORSATO, Giuseppe DIDONÈ, Emma FRASSON, Alberto POLO, Vincenza ARGENTIERO, Vincenzo ROMEO, Novenia PERLOTTO, Roberto L’ERARIO, Gianfranco MICAGLIO, Tiziana ROSSO, Sandro BRUNO, Bruno GIOMETTO, Mirco SERENA, Rocco QUATRALE, Ernesto GASTALDO, Francesco PERINI, Michele DILEONE, Alessandro CASANO, Lauretta SILVESTRI, Alessandro BURLINA, Virginia MUNERATI, Sebastiano D’Anna, Flavio SANSON, Valeria SARTORI, Giuseppe MORETTO, Giovanna SQUINTANI, Salvatore MONACO, Maria Donata BENEDETTI, Simone FUSINA, Claudio BIANCONI, Fabiana PIMAZZONI, Angela BONOMETTI, Giampietro ZANETTE, Marco TURATTI, Sardinia: Stefania LEONI, Giuseppe MURA, Anna TICCA, Piernicola MARCHI, Davide MANCA], Galeotti, F, Massari, M, D'Alessandro, R, Beghi, E, Chiò, A, Logroscino, G, Filippini, G, Benedetti, M, Pugliatti, M, Santuccio, C, Raschetti, R, Ferrarese, C, Benedetti, Md, ITANG study, Group, and Giometto, B

Subjects
Male, Epidemiology, Pharmaco-Epidemiology, medicine.disease_cause, MED/26 Neurologia, Influenza A Virus, H1N1 Subtype, Risk Factors, Influenza A virus, Odds Ratio, influenza vaccination, Guillain-Barré Syndrome, Case–control study, self controlled case series, Prospective Studies, Case-control study, Guillain-Barrè Syndrome, Influenza vaccination, Self controlled case series, Aged, 80 and over, Guillain-Barre syndrome, Respiratory tract infections, Incidence (epidemiology), Incidence, Middle Aged, Vaccination, Guillain-Barrè, epidemic risk , gastrointestinal and respiratory infections, Italy, Influenza Vaccines, Population Surveillance, Regression Analysis, Female, Settore MED/26 - Neurologia, Adult, medicine.medical_specialty, Guillain-Barre Syndrome, Mass Vaccination, NO, Internal medicine, Influenza, Human, medicine, Humans, Pandemics, Aged, business.industry, Odds ratio, medicine.disease, Relative risk, Case-Control Studies, Immunology, Attributable risk, business
Abstract

Influenza vaccination has been implicated in Guillain Barre Syndrome (GBS) although the evidence for this link is controversial. A case–control study was conducted between October 2010 and May 2011 in seven Italian Regions to explore the relation between influenza vaccination and GBS. The study included 176 GBS incident cases aged ≥18 years from 86 neurological centers. Controls were selected among patients admitted for acute conditions to the Emergency Department of the same hospital as cases. Each control was matched to a case by sex, age, Region and admission date. Two different analyses were conducted: a matched case–control analysis and a self-controlled case series analysis (SCCS). Case–control analysis included 140 cases matched to 308 controls. The adjusted matched odds ratio (OR) for GBS occurrence within 6 weeks after influenza vaccination was 3.8 (95 % CI: 1.3, 10.5). A much stronger association with gastrointestinal infections (OR = 23.8; 95 % CI 7.3, 77.6) and influenza-like illness or upper respiratory tract infections (OR = 11.5; 95 % CI 5.6, 23.5) was highlighted. The SCCS analysis included all 176 GBS cases. Influenza vaccination was associated with GBS, with a relative risk of 2.1 (95 % CI 1.1, 3.9). According to these results the attributable risk in adults ranges from two to five GBS cases per 1,000,000 vaccinations.

Published
2013

3. A Multicentric Prospective Incidence Study of Guillain-Barré Syndrome in Italy. The ITANG Study

Author

Benedetti, M, Pugliatti, M, Dalessandro, R, BEGHI, ETTORE, Chiò, A, Logroscino, G, Filippini, G, Galeotti, F, Massari, M, Santuccio, C, Raschetti, R, Abruzzi, L, Agazzi, E, Agostoni, E, Ambrogio, L, Amidei, S, Arbasino, C, Argentiero, V, Arnaboldi, M, Baldini, D, Barki, R, Bassi, P, Basso, F, Belcastro, V, Bellotti, M, Bersano, E, Besana, R, Bettoni, L, Bezzi, G, Bianconi, C, Bondavalli, M, Bonometti, A, Borghi, AM, Borsato, C, Bortolotto, S, Bottacchi, EF, Bresolin, N, Bruno, S, Burlina, A, Cafasso, G, Callegarini, C, Calvo, A, Candeloro, E, Casano, A, Cattaneo, SI, Cavallo, R, Cheldi, A, Ciardo, G, Cirignotta, F, Clerici, AM, Clerici, R, Comi, G, Conti, R, Coppo, F, Covelli, V, Crespi, V, Currò Dossi, M, Curtò, NA, D'Adda, E, Dallocchio, C, D'Anna, S, De Massis, P, De Toni Franceschini, L, Di Vito, N, Didonè, G, Dileone, M, Donati, E, Dotta, M, Fazio, R, Federico, F, FERRARESE, CARLO, Ferrazzini, F, Ferrero, B, Filosto, M, Frasson, E, Fusina, S, Galbussera, A, Gastaldo, E, Geda, C, Ghiglione, P, Giometto, B, Gionco, M, Giorgetti, A, Giussani, G, Gobbin, F, Grampa, G, Granieri, E, Greco, G, Guidetti, D, Guidi, C, Guidotti, M, Gusmaroli, G, Imperiale, D, Internò, S, Jann, S, La Spina, I, Leo, A, Leone, M, Leoni, S, Leotta, D, Lerario, R, Liotta, G, Livrea, P, Luda di Cortemiglio, E, Maggio, B, Magni, E, Magnoni, A, Maistrelli, J, Manca, D, Mandrioli, J, Manera, U, Marcello, N, Marchi, P, Marchini, C, Marconi, S, Mattioli, M, Mauro, A, Mazzaglia, G, Medici, D, Meineri, P, Meola, G, Micaglio, G, Michelucci, R, Michieli, G, Micieli, G, Minardi, C, Moglia, C, Monaco, S, Montanari, E, Moretto, G, Munerati, V, Mura, G, Mussutto, V, Nascimbene, C, Neri, W, Nichelli, P, Nobile Orazio, E, Oddenino, E, Onorato, S, Padovani, A, Palermo, M, Papurello, DM, Passarella, B, Pavesi, G, Penza, MT, Perini, M, Perini, F, Perla, F, Perlotto, N, Perrone, P, Pignatta, P, Pisano, F, Poglio, F, Polo, A, Poloni, M, Porazzi, D, Pradotto, L, Previdi, P, Quatrale, R, Rasi, F, Ravasio, A, Ravetti, C, Repaci, M, Riccardi, T, Riguzzi, P, Rinaldi, R, Riva, M, Romeo, V, Romorini, A, Rosso, T, Rotondo, G, Sacquegna, T, Sanson, F, Santamato, V, Santoro, D, Sartori, V, Sasanelli, F, Savio, K, Serena, M, Silani, V, Silvestri, L, Simioni, V, Squintani, GM, Suardelli, M, Tartagla, L, Terenghi, F, Terlizzi, E, Terzano, M, Tesser, F, Testa, L, Ticca, A, Ticozzi, N, Tiriticco, M, Tola, MR, Tonietti, S, Trianni, G, Trojano, M, Trotta, F, Turatti, M, Ursino, E, Vanotti, A, Vercellino, M, Villani, A, Vitelli, E, Zambito Marsala, S, Zanette, G, Zarcone, D, Zimatore, G, Zoccolella, S., Benedetti, Md, Pugliatti, M, D'Alessandro, R, Beghi, E, Chiò, A, Logroscino, G, Filippini, G, Galeotti, F, Massari, M, Santuccio, C, Comi, Giancarlo, Raschetti, R, ITANG Study, Group, Giometto, B, Benedetti, M, Dalessandro, R, Abruzzi, L, Agazzi, E, Agostoni, E, Ambrogio, L, Amidei, S, Arbasino, C, Argentiero, V, Arnaboldi, M, Baldini, D, Barki, R, Bassi, P, Basso, F, Belcastro, V, Bellotti, M, Bersano, E, Besana, R, Bettoni, L, Bezzi, G, Bianconi, C, Bondavalli, M, Bonometti, A, Borghi, A, Borsato, C, Bortolotto, S, Bottacchi, E, Bresolin, N, Bruno, S, Burlina, A, Cafasso, G, Callegarini, C, Calvo, A, Candeloro, E, Casano, A, Cattaneo, S, Cavallo, R, Cheldi, A, Ciardo, G, Cirignotta, F, Clerici, A, Clerici, R, Comi, G, Conti, R, Coppo, F, Covelli, V, Crespi, V, Currò Dossi, M, Curtò, N, D'Adda, E, Dallocchio, C, D'Anna, S, De Massis, P, De Toni Franceschini, L, Di Vito, N, Didonè, G, Dileone, M, Donati, E, Dotta, M, Fazio, R, Federico, F, Ferrarese, C, Ferrazzini, F, Ferrero, B, Filosto, M, Frasson, E, Fusina, S, Galbussera, A, Gastaldo, E, Geda, C, Ghiglione, P, Gionco, M, Giorgetti, A, Giussani, G, Gobbin, F, Grampa, G, Granieri, E, Greco, G, Guidetti, D, Guidi, C, Guidotti, M, Gusmaroli, G, Imperiale, D, Internò, S, Jann, S, La Spina, I, Leo, A, Leone, M, Leoni, S, Leotta, D, Lerario, R, Liotta, G, Livrea, P, Luda di Cortemiglio, E, Maggio, B, Magni, E, Magnoni, A, Maistrelli, J, Manca, D, Mandrioli, J, Manera, U, Marcello, N, Marchi, P, Marchini, C, Marconi, S, Mattioli, M, Mauro, A, Mazzaglia, G, Medici, D, Meineri, P, Meola, G, Micaglio, G, Michelucci, R, Michieli, G, Micieli, G, Minardi, C, Moglia, C, Monaco, S, Montanari, E, Moretto, G, Munerati, V, Mura, G, Mussutto, V, Nascimbene, C, Neri, W, Nichelli, P, Nobile Orazio, E, Oddenino, E, Onorato, S, Padovani, A, Palermo, M, Papurello, D, Passarella, B, Pavesi, G, Penza, M, Perini, M, Perini, F, Perla, F, Perlotto, N, Perrone, P, Pignatta, P, Pisano, F, Poglio, F, Polo, A, Poloni, M, Porazzi, D, Pradotto, L, Previdi, P, Quatrale, R, Rasi, F, Ravasio, A, Ravetti, C, Repaci, M, Riccardi, T, Riguzzi, P, Rinaldi, R, Riva, M, Romeo, V, Romorini, A, Rosso, T, Rotondo, G, Sacquegna, T, Sanson, F, Santamato, V, Santoro, D, Sartori, V, Sasanelli, F, Savio, K, Serena, M, Silani, V, Silvestri, L, Simioni, V, Squintani, G, Suardelli, M, Tartagla, L, Terenghi, F, Terlizzi, E, Terzano, M, Tesser, F, Testa, L, Ticca, A, Ticozzi, N, Tiriticco, M, Tola, M, Tonietti, S, Trianni, G, Trojano, M, Trotta, F, Turatti, M, Ursino, E, Vanotti, A, Vercellino, M, Villani, A, Vitelli, E, Zambito Marsala, S, Zanette, G, Zarcone, D, Zimatore, G, and Zoccolella, S

Subjects
Adult, Male, Pediatrics, medicine.medical_specialty, Epidemiology, Population, Guillain-Barre Syndrome, Rate ratio, NO, Young Adult, Axonal and demyelinating GBS, Guillain-Barré syndrome, Incidence, Prospective study, Trend, Neurology (clinical), Aged, Aged, 80 and over, Female, Humans, Italy, Middle Aged, 80 and over, medicine, Young adult, education, Prospective cohort study, education.field_of_study, Guillain-Barre syndrome, business.industry, Medicine (all), Incidence (epidemiology), medicine.disease, Vaccination, Settore MED/26 - NEUROLOGIA, business, Human
Abstract

Background: To assess Guillain-Barré syndrome (GBS) incidence we relied on the Italian Network for the study of GBS (ITANG) established in 2010 in 7 Italian regions to analyse the association between influenza vaccination and GBS. Methods: All individuals aged ≥18 years, presenting with clinical manifestations that suggested GBS according to the universally accepted Asbury's diagnostic criteria (1990) were prospectively notified to a centralised database by ITANG neurologists over the period October 1, 2010-September 30, 2011. Through a telephone survey, 9 trained interviewers followed up the cases to diagnosis and then for 1 year since hospital discharge. Validation of case reporting was performed with the support of administrative data in 5 regions. Results: We found 365 cases fulfilling the definition for GBS or one of its variants over 19,846,068 population ≥18 years of age, yielding an annual incidence rate of 1.84 per 100,000 (95% CI 1.65-2.03), 2.30 (95% CI 1.99-2.60) in men and 1.41 (95% CI 1.18-1.64) in women. A highly significant peak of incidence was observed in February 2011 as compared to reference month (September 2011, rate ratio 3.3:1, p < 0.01). Conclusions: In Italy, GBS incidence was among the highest reported in Europe and higher than previously observed in Italian studies.

Published
2015

4. Spontaneous reports of vasculitis as an adverse event following immunization: A descriptive analysis across three international databases

Author

Felicetti, P, Trotta, F, Bonetto, C, Santuccio, C, Brauchli Pernus, Y, Burgner, D, Chandler, R, Girolomoni, Giampiero, Hadden, Rd, Kochar, S, Kucuku, M, Monaco, G, Ozen, S, Pahud, B, Phuong, L, Bachtiar, Ns, Teeba, A, Top, K, Varricchio, F, Wise, Rp, Zanoni, G, Živkovic, S, Bonhoeffer, J, and Brighton, Collaboration Vasculitis Working Group

Subjects
Male, Pediatrics, Databases, Factual, Global Health, Spontaneous reporting, 0302 clinical medicine, Prevalence, Medicine, 030212 general & internal medicine, Young adult, Child, Aged, 80 and over, Vaccines, Middle Aged, Vaccination, Infectious Diseases, Child, Preschool, Molecular Medicine, Female, Vasculitis, Adult, medicine.medical_specialty, Adolescent, Eudravigilance, 03 medical and health sciences, Young Adult, Pharmacovigilance, Adverse Drug Reaction Reporting Systems, Humans, VAERS, Adverse effect, Adverse event following immunization(AEFI), Aged, 030203 arthritis & rheumatology, General Veterinary, General Immunology and Microbiology, Descriptive statistics, business.industry, Public Health, Environmental and Occupational Health, Infant, Newborn, Infant, Pharmacovigilancea, medicine.disease, Immunization, VigiBase®, Vasculitis,Vaccines,Immunization,Adverse event following immunization(AEFI),Spontaneous reporting,Eudravigilance,VigiBase®,VAERS,Pharmacovigilancea, business
Abstract

Vasculitides have been reported as adverse events following immunization (AEFI) following various vaccines. We describe reports of vasculitis to three international spontaneous reporting systems.All spontaneous reports of vasculitis following immunization between January 2003 and June 2014 were retrieved from Eudravigilance (EV), the Vaccine Adverse Event Reporting System (VAERS), and VigiBaseWe retrieved 1797 reports of vasculitis in EV, 1171 in VAERS, and 2606 in VigiBaseSimilar reporting patterns of vasculitides were observed in different databases. Implementation of standardized case definitions for specific vasculitides could improve overall data quality and comparability of reports.

Published
2015

5. Comparative safety evaluation of 7-valent and 13-valent pneumococcal vaccines in routine paediatric vaccinations in four Italian regions, 2009 to 2011

Author

Trotta F, Rizzo C, Santuccio C, Bella A, and Pharmacovigilance Study Group On Pneumococcal Vaccination In Children

Subjects
Male, Single administration, Pediatrics, medicine.medical_specialty, Heptavalent Pneumococcal Conjugate Vaccine, Epidemiology, Comparative safety, Rate ratio, Pneumococcal Infections, Pneumococcal Vaccines, Conjugate vaccine, Virology, Convulsion, medicine, Adverse Drug Reaction Reporting Systems, Humans, Adverse effect, Immunization Schedule, Immunization Programs, business.industry, Vaccination, Public Health, Environmental and Occupational Health, Infant, Antibodies, Bacterial, Confidence interval, Italy, Child, Preschool, Immunology, Female, medicine.symptom, business
Abstract

This study was aimed at estimating the risk of all types of adverse events following immunisation (AEFI), neurological events and convulsions following the co-administration of 13-valent pneumococcal polysaccharide conjugate vaccine (PCV13) with hexavalent vaccine. Paediatric spontaneous reports and exposure to vaccinations in four Italian regions were available. The estimated incidence rate ratio (IRR) for AEFI following co-administration of hexavalent vaccine with either PCV13 or PCV7 was 1.08 (95% confidence interval (CI): 0.91-1.28); the IRR for, respectively, neurological events and convulsion following co-administration of PCV13 with hexavalent vaccine were 1.27 (95% CI: 0.85-1.89) and 1.43 (95% CI: 0.70-2.91). Co-administration of PCV13 with hexavalent vaccine had a protective effect against AEFI (IRR?=?0.59; 95% CI: 0.49-0.72). This protective effect was not observed for neurological events or convulsions following co-administration of PCV13 with hexavalent vaccine compared with single administration (IRR?=?1.44; 95% CI: 0.77-2.67 and IRR?=?1.46; 95% CI: 0.50-4.25, respectively). We observed a trend of increased risk of neurological events or convulsions following PCV13 used in routine practice. Analysis of spontaneously reported data is a quick method to estimate associations between vaccines and less common adverse events. Given methodological limitations these findings cannot be conclusive and require further investigations. .

Published
2015
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6. Vaccine effectiveness against severe laboratory-confirmed influenza in children: results of two consecutive seasons in Italy

Author

Menniti Ippolito, F, Da Cas, R, Traversa, G, Santuccio, C, Felicetti, P, Tartaglia, L, Trotta, F, Di Pietro, P, Barabino, P, Renna, S, Riceputi, L, Tovo, Pier Angelo, Gabiano, C, Urbino, A, Baroero, L, Le Serre, D, Virano, S, Perilongo, G, Daverio, M, Gnoato, E, Maretti, M, Galeazzo, B, Rubin, G, Scanferla, S, Da Dalt, L, Stefani, C, Zerbinati, C, Chiappini, E, Sollai, S, De Martino, M, Mannelli, F, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Furbetta, M, Abate, P, Leonardi, I, Pirozzi, N, Raucci, U, Reale, A, Rossi, R, Russo, C, Mancinelli, L, Manuela, O, Carlo, C, Mores, N, Romagnoli, C, Chiaretti, A, Compagnone, A, Riccardi, R, Delogu, G, Sali, M, Prete, V, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T, Sodano, G, Maccariello, A, Rafaniello, C, Fucà, F, Di Rosa, E, Altavilla, D, Mecchio, A, Arrigo, T, Italian Multicentre Study Group for Drug, Vaccine Safety in Children, Menniti Ippolito, Francesca, Da Cas, Roberto, Traversa, Giuseppe, Santuccio, Carmela, Felicetti, Patrizia, Tartaglia, Loriana, Trotta, Francesco, Di Pietro, Pasquale, Barabino, Paola, Renna, Salvatore, Riceputi, Laura, Tovo, Pier Angelo, Gabiano, Clara, Urbino, Antonio, Baroero, Luca, Le Serre, Daniele, Virano, Silvia, Perilongo, Giorgio, Daverio, Marco, Gnoato, Elisa, Maretti, Michela, Galeazzo, Beatrice, Rubin, Giulia, Scanferla, Stefania, Da Dalt, Liviana, Stefani, Chiara, Zerbinati, Claudia, Chiappini, Elena, Sollai, Sara, De Martino, Maurizio, Mannelli, Francesco, Becciani, Sabrina, Giacalone, Martina, Montano, Simona, Remaschi, Giulia, Stival, Alessia, Furbetta, Mario, Abate, Piera, Leonardi, Ilaria, Pirozzi, Nicola, Raucci, Umberto, Reale, Antonino, Rossi, Rossella, Russo, Cristina, Mancinelli, Livia, Manuela, Onori, Carlo, Concato, Mores, Nadia, Romagnoli, Costantino, Chiaretti, Antonio, Compagnone, Adele, Riccardi, Riccardo, Delogu, Giovanni, Sali, Michela, Prete, Valentina, Tipo, Vincenzo, Dinardo, Michele, Auricchio, Fabiana, Polimeno, Teodoro, Sodano, Giuseppe, Maccariello, Alessandra, Rafaniello, Concetta, Fucà, Fortunata, Di Rosa, Eleonora, Altavilla, Domenica, Mecchio, Anna, and Arrigo, Teresa

Subjects
Male, Pediatrics, Laboratory-confirmed case, Emergency Medical Services, Immunology and Microbiology (all), Laboratory-confirmed cases, Case-control study, Children, Influenza vaccine effectiveness, Seasonal influenza, Influenza vaccine effectivene, Emergency medical services, Medicine, Child, Vaccine effectiveness, Vaccination, Hospitalization, Systematic review, Infectious Diseases, Treatment Outcome, Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA, Italy, Influenza Vaccines, Child, Preschool, Molecular Medicine, Veterinary (all), Female, Case-Control Studie, Influenza Vaccine, Settore BIO/19 - MICROBIOLOGIA GENERALE, Human, medicine.medical_specialty, Settore BIO/14 - FARMACOLOGIA, Adolescent, Settore MED/07 - MICROBIOLOGIA E MICROBIOLOGIA CLINICA, Immunology and Microbiology(all), Influenza, Human, Humans, Influenza-like illness, General Veterinary, General Immunology and Microbiology, business.industry, Emergency Medical Service, Public Health, Environmental and Occupational Health, Infant, Emergency department, veterinary(all), Confidence interval, Surgery, Case-Control Studies, Case-control study, Children, Influenza vaccine effectiveness, Laboratory-confirmed cases, influenza in children, business
Abstract

•Vaccine effectiveness in children visiting an Emergency Department for influenza.•Test negative case-control study in 11 paediatric centres in two influenza seasons.•Vaccine effectiveness in preventing ED visits: 38% (95% CI -52% to 75%).•Add information for recommendation for vaccination in children. Objective: To evaluate the effectiveness of seasonal influenza vaccine in preventing Emergency Department (ED) visits and hospitalisations for influenza like illness (ILI) in children. Methods: We conducted a test negative case-control study during the 2011-2012 and 2012-2013 influenza seasons. Eleven paediatric hospital/wards in seven Italian regions participated in the study. Consecutive children visiting the ED with an ILI, as diagnosed by the doctor according to the European Centre for Disease Control case definition, were eligible for the study. Data were collected from trained pharmacists/physicians by interviewing parents during the ED visit (or hospital admission) of their children. An influenza microbiological test (RT-PCR) was carried out in all children. Results: Seven-hundred and four children, from 6 months to 16 years of age, were enrolled: 262 children tested positive for one of the influenza viruses (cases) and 442 tested negative (controls). Cases were older than controls (median age 46 vs. 29 months), though with a similar prevalence of chronic conditions. Only 25 children (4%) were vaccinated in the study period. The overall age-adjusted vaccine effectiveness (VE) was 38% (95% confidence interval -52% to 75%). A higher VE was estimated for hospitalised children (53%; 95% confidence interval -45% to 85%). Discussion: This study supports the effectiveness of the seasonal influenza vaccine in preventing visits to the EDs and hospitalisations for ILI in children, although the estimates were not statistically significant and with wide confidence intervals. Future systematic reviews of available data will provide more robust evidence for recommending influenza vaccination in children. © 2014 The Authors.

Published
2013

7. Henoch-Schönlein purpura and drug and vaccine use in childhood: a case-control study

Author

Da Dalt, L, Zerbinati, C, Strafella, Ms, Renna, S, Riceputi, L, Di Pietro, P, Barabino, P, Scanferla, S, Raucci, U, Mores, N, Compagnone, A, Da Cas, R, Menniti Ippolito, F, Italian Multicenter Study Group for Drug, Vaccine Safety in Children including Menniti Ippolito, F, Traversa, G, Santuccio, C, Felicetti, P, Tartaglia, L, Trotta, F, Tovo, Pier Angelo, Gabiano, C, Urbino, A, Baroero, Luca, LE SERRE, Daniele, Virano, Silvia, Stefani, C, Perilongo, G, Daverio, M, Maretti, M, Galeazzo, B, Rubin, G, Chiappini, E, Sollai, S, De Martino, M, Becciani, S, Giacalone, M, Montano, S, Remaschi, G, Stival, A, Abate, P, Leonardi, I, Pirozzi, N, Reale, A, Rossi, R, Bersani, G, Chiaretti, A, Riccardi, R, Romagnoli, C, Tipo, V, Dinardo, M, Auricchio, F, Polimeno, T, Bonagura, M, Maccariello, A, Fucà, F, Di Rosa, E, Altavilla, D, Mecchio, A, and Arrigo, T.

Subjects
Male, Drug, Pediatrics, medicine.medical_specialty, Henoch-Schonlein purpura, Adolescent, Drug-Related Side Effects and Adverse Reactions, IgA Vasculitis, media_common.quotation_subject, Adverse drug reaction, Disease, MMR vaccine, Risk Assessment, Statistics, Nonparametric, 03 medical and health sciences, Age Distribution, 0302 clinical medicine, 030225 pediatrics, Confidence Intervals, medicine, Humans, Children, Henoch-Schönlein purpura, Vaccine, Pediatrics, Perinatology and Child Health, Sex Distribution, Child, media_common, 030203 arthritis & rheumatology, Chi-Square Distribution, business.industry, Incidence, Research, Case-control study, Reproducibility of Results, Perinatology and Child Health, medicine.disease, Italy, Pharmaceutical Preparations, Case-Control Studies, Child, Preschool, Etiology, Female, business, Vasculitis, Measles-Mumps-Rubella Vaccine, Follow-Up Studies
Abstract

Background Henoch-Schönlein purpura (HSP) is the most common vasculitis in childhood; nevertheless, its etiology and pathogenesis remain unknown despite the fact that a variety of factors, mainly infectious agents, drugs and vaccines have been suggested as triggers for the disease. The aim of this study was to estimate the association of HSP with drug and vaccine administration in a pediatric population. Methods An active surveillance on drug and vaccine safety in children is ongoing in 11 clinical centers in Italy. All children hospitalized through the local Paediatric Emergency Department for selected acute clinical conditions of interest were enrolled in the study. Data on drug and vaccine use in children before the onset of symptoms leading to hospitalization were collected by parents interview. A case-control design was applied for risk estimates: exposure in children with HSP, included as cases, was compared with similar exposure in children with gastroduodenal lesions, enrolled as controls. HSP cases were validated according to EULAR/PRINTO/PRES criteria. Validation was conducted retrieving data from individual patient clinical record. Results During the study period (November 1999–April 2013), 288 cases and 617 controls were included. No increased risk of HSP was estimated for any drug. Among vaccines, measles-mumps-rubella (MMR) vaccine showed an increased risk of HSP (OR 3.4; 95 % CI 1.2–10.0). Conclusions This study provides further evidence on the possible role of MMR vaccine in HSP occurrence.

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