Immunol Res. 2013 Apr 11. Cerpa-Cruz S, Paredes-Casillas P, Landeros Navarro E, Bernard-Medina AG, Martínez-Bonilla G, Gutiérrez-Ureña S.
Rheumatology and Immunology Department, Hospital Civil de Guadalajara «Fray Antonio Alcalde», Hospital 278, SH, Colonia El Retiro, 44280, Guadalajara, Jalisco, Mexico,
A traditional infectious disease vaccine is a preparation of live attenuated, inactivated or killed pathogen that stimulates immunity. Vaccine immunologic adjuvants are compounds incorporated into vaccines to enhance immunogenicity. Adjuvants have recently been implicated in the new syndrome named ASIA autoimmune/inflammatory syndrome induced by adjuvants. The objective describes the frequencies of post-vaccination clinical syndrome induced by adjuvants. We performed a cross-sectional study; adverse event following immunization was defined as any untoward medical occurrence that follows immunization 54 days prior to the event. Data on vaccinations and other risk factors were obtained from daily epidemiologic surveillance. Descriptive statistics were done using means and standard deviation, and odds ratio adjusted for potential confounding variables was calculated with SPSS 17 software. Forty-three out of 120 patients with moderate or severe manifestations following immunization were hospitalized from 2008 to 2011. All patients fulfilled at least 2 major and 1 minor criteria suggested by Shoenfeld and Agmon-Levin for ASIA diagnosis. The most frequent clinical findings were pyrexia 68 %, arthralgias 47 %, cutaneous disorders 33 %, muscle weakness 16 % and myalgias 14 %. Three patients had diagnosis of Guillain-Barre syndrome, one patient had Adult-Still’s disease 3 days after vaccination. A total of 76 % of the events occurred in the first 3 days post-vaccination. Two patients with previous autoimmune disease showed severe adverse reactions with the reactivation of their illness. Minor local reactions were present in 49 % of patients. Vaccines containing adjuvants may be associated with an increased risk of autoimmune/inflammatory adverse events following immunization.
Se debe recordar que las vacunas son unos de los pilares de la salud pública que mejoraron la calidad de vida y la muertes por pandemias. Se calculan en cientos de milones de humanos vacunados con diferentes tipos de drogas, y si bien el riesgo es real, las cifras están acorde con la aparición de esas mismas patologías aún sin vacunarse. En estos momentos es muy fuerte el movmiento de muchas organizaciones, para ir en contra de la inmunización, aduciendo efectos adversos y ventajas económicas para la industria. El clínico debe tener el equilibrio justo para evitar en cualquier fundamentalismo. Carlos Panzeri