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J Pediatric Infect Dis Soc. 2017 Sep 1;6(3):e161-e164. doi: 10.1093/jpids/piw084.

Arm Paralysis After Routine Childhood Vaccinations: Application of Advanced Molecular Methods to the Causality Assessment of an Adverse Event After Immunization.

Author information

1
Department of Pediatrics, Division of Infectious Diseases, State University of New York Upstate Medical University, Golisano Children's Hospital, Syracuse.
2
Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
3
Departments of Pediatrics, Medicine and Pathology, Director, Molecular and Virology Clinical Laboratories, University of Colorado Denver, Aurora.
4
National Center for Immunizations and Respiratory Diseases, Division of Viral Diseases, Atlanta, Georgia.
5
Laboratory of Viral Diseases, Wadsworth Center, New York State Department of Health, Clinical Professor, Department of Biomedical Sciences, University at Albany, SUNY.
6
Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
7
Pediatrics, Divisions of Immunobiology, and Bone Marrow Transplantation and Immune Deficiency Cincinnati Children's Hospital/University of Cincinnati, Ohio.
8
Laboratory of Viral Diseases, Wadsworth Center, New York State Department of Health, Albany.
9
Department of Pediatrics, Division of Pediatric Infectious Diseases, Columbia University, New York, New York.
10
Department of Neurology, Upstate Medical University, New York, New York.
11
Centers for Disease Control and Prevention, National Center for Emerging, Zoonotic, and Infectious Diseases, Division of Healthcare Quality Promotion, Immunization Safety Office, Clinical Immunization Safety Assessment Project, Atlanta, Georgia.
12
Columbia University College of Physicians and Surgeons, New York, New York.

Abstract

Post-licensure surveillance for adverse events following immunizations (AEFI) can identify rare complications of vaccinations and rigorous vaccine adverse event causality assessments can help to identify possible causal relationships. We report the development of arm paralysis after varicella vaccination in a 1-year-old child. Paralysis was initially presumed to be due to vOka because of the temporal relationship between vaccination and onset of arm weakness; however, molecular studies identified wild-type varicella zoster virus VZV (WT-VZV) in the CSF, leading the authors to conclude that WT-VZV was the probable cause. This case illustrates the complexity of assessing AEFI causality, and the importance of careful and complete evaluations when determining the most likely cause of an AEFI.

KEYWORDS:

adverse event after vaccination; child; paralysis; vaccine; varicella-zoster virus

PMID:
28339574
PMCID:
PMC6251534
DOI:
10.1093/jpids/piw084
[Indexed for MEDLINE]
Free PMC Article

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