Kawasaki disease and vasculitis associated with immunization

Abstract

The etiology and pathogenesis of Kawasaki Disease (KD) remain poorly understood. Amongst the diverse infectious and environmental factors examined to be triggers for, or be associated with KD, are immunizations. In this report, we first describe a Caucasian female who presented with classic KD shortly after receiving her routine 4 month vaccination series. Prior published case reports and large epidemiological studies, which explore potential associations between immunizations and KD and other vasculitides, are then comprehensively reviewed. The methodologic challenges which complicate analysis in this area are also considered. This article is protected by copyright. All rights reserved.

Kawasaki Disease and the Use of the Rotavirus Vaccine in Children: A Systematic Review and Meta-Analysis

“…One case report described a 4-month-old Caucasian child, presenting classic Kawasaki disease shortly after receiving vaccines (pneumococcal 13, diphtheria–tetanus–pertussis, polio, Hepatitis B, and rotavirus vaccine). The case supports that vaccines may be associated with vasculitis and Kawasaki disease and that ongoing, systematic surveillance of such events is warranted (Chang and Islam, 2018).…”

“…The characteristics and outcomes of the studies included are given in Table 1 (descending order of year of publication). This review found information in: two case reports (Uhlig et al, 2014; Chang and Islam, 2018), four cohort studies (Belongia et al, 2010; Loughlin et al, 2012; Layton et al, 2018; RotaTeq, 2017), one cross-sectional study (Oberle et al, 2010), three adverse event reports (Geier et al, 2008; Hua et al, 2009; Paulke-Korinek et al, 2013), and four RCTs (Phua et al, 2005; Salinas et al, 2005; Phua et al, 2009; RotaTeq, 2017).…”

Occurrence of Kawasaki disease after simultaneous immunization

“…A recent population‐based study has shown that vaccinations did not increase the risk of Kawasaki disease (KD) . In contrast, various vaccines, including those against rotavirus, hepatitis B, and influenza, have been suggested to be triggers for KD occurrence . We report a pediatric case of KD that occurred after simultaneous immunization with measles/rubella, varicella, and pneumococcal vaccine, suggesting that the vaccination is associated with KD.…”

“…The present patient had the onset of KD only 1 day after the immunization: this rapidity/temporality is very limited. According to the review by Chang and Islam, only four cases were reported in which KD manifested ≤1 day after immunization, or KD symptoms appeared ≤12 h after the second shot of various vaccines . They speculated that this rapidity of symptom occurrence reflects “antigen sensitization” due to previous exposure to antigens, and is an immune‐mediated phenomenon.…”

Perspective of Immunopathogenesis and Immunotherapies for Kawasaki Disease

“…Interestingly, the MIS-C cases are mostly reported from Italy, France, UK, and USA but not found in Asia, where the incidence of KD is 10 times higher than that in Western countries (24,27). It is worth to mention previous reports of increasing KD incidences after hepatitis B and influenza vaccinations (28)(29)(30). There is also evidence of autoimmune disease flared up after SARS-CoV-2 vaccination recently (31).…”