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Do Combination Vaccines or Simultaneous Vaccination Increase the Risk of Adverse Events?

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Abstract

Certain combination vaccines or simultaneous administration of vaccines that are known to cause fever can rarely cause febrile seizures in infants and young children beyond the risk presented by individually administered vaccines. Specifically, the rate of febrile seizures in the 7-10 days after vaccination was approximately 2-3 times higher for children who received MMRV as compared to MMR and varicella vaccines administered separately on the same day and 4 times higher as compared to MMR alone, and when influenza and pneumococcal conjugate vaccines are given simultaneously as opposed to separately in children 6-59 months of age, the risk of febrile seizures in the 24 hours after vaccination increases from roughly 5 to 17.5 per 100,000 doses. Simultaneous administration of Tdap and influenza vaccines during pregnancy does not increase the risk of acute adverse events or adverse birth outcomes. Combination vaccines and simultaneous administration of vaccines currently routinely recommended to the general population in the U.S. have not been shown to cause any other adverse events at a greater rate than their individual vaccine components.

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Notes

  1. 1.

    These conclusions do not necessarily consider vaccines recommended only for special populations in the United States such as Yellow Fever vaccine (international travelers) or Smallpox vaccine (military personnel).

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Author information

Authors and Affiliations

  1. Epidemiologist, Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Matthew Z. Dudley PhD, MSPH

  2. Professor, Departments of International Health and Health, Behavior and Society, Director, Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Daniel A. Salmon PhD, MPH

  3. Professor Emeritus, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Professor Emeritus, Department of Pediatrics, Johns Hopkins School of Medicine, Director Emeritus, Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Neal A. Halsey MD

  4. Professor of Medicine, Pediatrics, Global Health, and Epidemiology, Emory University, Associate Director, Emory Vaccine Center, Director, Center of Excellence for Influenza Research and Surveillance (Emory-UGA CEIRS), Former President, National Foundation for Infectious Diseases (NFID), Atlanta, GA, USA

    Walter A. Orenstein MD, DSc (Hon)

  5. Associate Director for Behavioral Research, Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA

    Rupali J. Limaye PhD, MPH, MA

  6. Associate Professor, Pediatrics-Infectious Diseases, University of Colorado School of Medicine, Denver, CO, USA

    Sean T. O’Leary MD, MPH

  7. William H. Foege Professor of Global Health, Professor of Epidemiology and Pediatrics, Emory University, Atlanta, GA, USA

    Saad B. Omer MBBS, PhD, MPH

Authors
  1. Matthew Z. Dudley PhD, MSPH
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  2. Daniel A. Salmon PhD, MPH
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  3. Neal A. Halsey MD
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  4. Walter A. Orenstein MD, DSc (Hon)
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  5. Rupali J. Limaye PhD, MPH, MA
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  6. Sean T. O’Leary MD, MPH
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  7. Saad B. Omer MBBS, PhD, MPH
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Dudley, M.Z. et al. (2018). Do Combination Vaccines or Simultaneous Vaccination Increase the Risk of Adverse Events?. In: The Clinician’s Vaccine Safety Resource Guide. Springer, Cham. https://doi.org/10.1007/978-3-319-94694-8_20

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  • DOI: https://doi.org/10.1007/978-3-319-94694-8_20

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-94694-8

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