Further Experience of Reactions, Especially of a Cerebral Nature, in Conjunction with Triple Vaccination: A Study Based on Vaccinations in Sweden 1959–65

Abstract

Among 516,276 triple-vaccinated children in Sweden from 1959 to 1965 neurological reactions to the vaccination occurred in 167 cases—destructive encephalopathy 3, convulsions 80, hypsarrhythmia 4, shock 54, uncontrollable screaming 24, serous meningitis 2. Serous meningitis was also found in three out of nine examined cases of convulsions, and elevated protein in cerebrospinal fluid in one out of four examined cases of shock. Apart from these objective signs of meningeal involvement in certain cases, the study shows that in conjunction with both convulsions and shock there may be no or very little rise of temperature. The convulsive symptoms therefore cannot be classified as a matter of course as simple febrile convulsions. The incidence of neurological reactions was 1:3,600 vaccinated children (1:3,100 if cases of persistent uncontrollable screaming are included), a rise in relation to the figure of 1:6,000 reported in a study from the years 1954 to 1958. The rise is probably merely apparent, however, owing to the more watchful eye that is kept on these conditions. The more severe reactions leading to permanent injury seem to have decreased. Analysis of the vaccinations of 208,186 children showed that 75.3% had been completely vaccinated. The figure for the non-vaccinated was 16.4%, rather more than half of them due to the parents’ refusal. Vaccination had not been completed in 8.3% ; in at least 3% the reason was probably the severe reaction to a preceding vaccination. Apart from neurological reactions, erythema, exanthema, oedema, and gastrointestinal symptoms have also been reported. The great majority of reactions occurred after the first injection. Repeated injection appeared to produce the same reaction. All forms of reaction can be explained as being of toxic origin. An allergic mechanism would appear to be of relatively limited significance ; a certain individual predisposition, however, seems to be a factor to reckon with. Finally, it is emphasized that when nation-wide vaccination is recommended detailed information should be required concerning postvaccinal reactions, as is done in Sweden in conjunction with triple vaccination. © 1967, British Medical Journal Publishing Group. All rights reserved.