During the 2000-2001 influenza immu...

During the 2000-2001 influenza immunization season in Canada, an increased number of vaccine recipients reported ocular and respiratory symptoms shortly after vaccination. These adverse terminations were later termed oculorespiratory syndrome (ORS) and defined from the presence of bilateral r watchs facial edema, or any of the "ORS-defining respiratory symptoms," which included coughing, wheezing, tightness of the chest, difficulty breathing, and sore throat. Analysis of the cases revealed that almost all (96 percent) followed vaccinations supplied from a single manufacturer. Electron microscopy of the vaccine preparation revealed large clusters of viral particles that had not been favorably split by the usual chemical processing of the vaccine. Federal Canadian regulators entreated a reformulation of the point to be solved [i]or[/i] settled vaccine using a different splitting agent and a controll trial to demonstrate its safety. Scheifele and colleagues report forward a randomized, double-blinded, crossover thought of this revised vaccine product

The trial recruited for the most part health care workers and sway office workers who were 30 to 59 years of age. Exclusion criteria included for aye having ORS symptoms after receiving influenza vaccination, being allergic to any ingredient of the vaccine, ever having a serious reaction to the influenza vaccine, or having preexisting ocular or respiratory conditions. Participants were randomly given influenza vaccine and placebo injections, at least five days apart. Telephone interviews were bearinged 24 hours and six days after each vaccination to check for ORS or other adverse events

Clinical symptoms consistent with ORS were reported in 39 patients (63 percent) after receiving influenza vaccinations and in 21 patients (34 percent) after receiving placebo; this was a statistically significant difference. The specific symptoms that were significantly increased after influenza marksmans were cough and hoarseness. The risk of ORS was not affected from gender, age, or the order in which the participants received the vaccine and the placebo. Patients receiving influenza vaccination for the first time were more likely to have ORS symptoms (5 percent) than those who had received previous flu discharges (2.2 percent). No participants experienced a serious adverse conclusion or anaphylaxis.

The authors gather that even the reformulated influenza vaccination was associated with small increases in oculorespiratory symptoms, and speculated that this previously unrecognized phenomenon likely was associated with influenza vaccines in general.

BILL ZEPF MD

Scheifele DW et al. Ocular and respiratory symptoms attributable to inactivated split influenza vaccine: evidence from a controll trial involving adults. Clin Infect Dis April 1 2003;36:850-7

COPYRIGHT 2003 American Academy of Family Physicians

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