Systemic inflammatory reaction after pneumococcal vaccine

Elten, Kelley A von; Duran, Laurie; Banks, Taylor A.; Collins, Limone

doi:10.4161/hv.28559

Cited by 15 publications

(8 citation statements)

References 5 publications

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“…The Journal of Immunology are not unique to MDSCs and are likely operative in many other cell subsets. Nevertheless, innate immune activation at the vaccine injection site is necessary to induce sufficient adaptive vaccine responses, but it needs to resolve rapidly to avoid local or systemic side effects (39,40). We speculate that infiltration of immune-suppressive cells along with immune-stimulatory cells is physiologically important to prevent overreactive responses.…”

Section: Discussionmentioning

confidence: 98%

Rhesus Macaque Myeloid-Derived Suppressor Cells Demonstrate T Cell Inhibitory Functions and Are Transiently Increased after Vaccination

Lin

Liang

Thompson

et al. 2018

The Journal of Immunology

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Myeloid-derived suppressor cells (MDSCs) are major regulators of T cell responses in several pathological conditions. Whether MDSCs increase and influence T cell responses in temporary inflammation, such as after vaccine administration, is unknown. Using the rhesus macaque model, which is critical for late-stage vaccine testing, we demonstrate that monocytic (M)-MDSCs and polymorphonuclear (PMN)-MDSCs can be detected using several of the markers used in humans. However, whereas rhesus M-MDSCs lacked expression of CD33, PMN-MDSCs were identified as CD33 low-density neutrophils. Importantly, both M-MDSCs and PMN-MDSCs showed suppression of T cell proliferation in vitro. The frequency of circulating MDSCs rapidly and transiently increased 24 h after vaccine administration. M-MDSCs infiltrated the vaccine injection site, but not vaccine-draining lymph nodes. This was accompanied by upregulation of genes relevant to MDSCs such as arginase-1, IDO1, PDL1, and IL-10 at the injection site. MDSCs may therefore play a role in locally maintaining immune balance during vaccine-induced inflammation.

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Section: Discussionmentioning

confidence: 98%

Rhesus Macaque Myeloid-Derived Suppressor Cells Demonstrate T Cell Inhibitory Functions and Are Transiently Increased after Vaccination

Lin

Liang

Thompson

et al. 2018

The Journal of Immunology

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“…Additionally, a significant number (25 cases, 45%) of soft tissue infections, including cellulitis, resulted from PPV23-related cases. However, one-third of these subjects developed initial symptoms on the day of vaccination, which implies that some cases may not have resulted from inoculation site infection, but from another systemic inflammatory reaction to the antigen or vaccine ingredients [ 17 ]. Further studies to review cellulitis-like adverse events following PPV23 in Korea should be conducted in order to prevent unnecessary antibiotic use and hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Surveillance and compensation claims for adverse events following immunization from 2011 to 2016 in the Republic of Korea

Kim

Lee

Kim

et al. 2017

Clin Exp Vaccine Res

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PurposeIn recent years, research on reported adverse events following immunization (AEFI) and claims filed for compensation has been lacking. We reviewed reported AEFIs and compensation claims in Korea from 2011 to 2016.Materials and MethodsWe listed all of the AEFI registered in the Integrated Management System of Disease and Public Health and reviewed the list of claims filed and serious AEFIs reported from 2011 to 2016.ResultsAn average of 278 AEFI cases was reported annually from 2011 to 2016. Of these, 31 deaths were reported. However, there was no association found between these deaths and vaccinations when evaluating vaccine lot, reviewing autopsies, and considering underlying diseases. AEFI reporting rate was as high as 20.8 cases for bacillus Calmette–Guérin (BCG) vaccine, 7.3 cases for 23-valent pneumococcal polysaccharide vaccine (PPV23), and 5.4 cases for human papillomavirus vaccine per 100,000 vaccination doses in 2016. Of the 469 total cases that claimed vaccine injury compensation from 2011 to 2016, the BCG vaccine was most commonly involved, with 235 cases (50%), followed by influenza vaccine and PPV23, with 90 and 55 cases, respectively. Of these cases, 96% of BCG-related AEFI were compensated, while only 31% and 49% of AEFI following influenza and PPV23 vaccination, respectively, were compensated. Common characteristics of uncompensated cases included the elderly subjects, receiving influenza vaccine, having underlying disease, or a very short time interval between vaccination and symptoms.ConclusionWe have maintained vaccine safety management system through both rapid response to serious AEFI and vaccine injury compensation in order to sustain public trust in the National Immunization Program.

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“… 7 Reports of small case series, however, also suggested an association of ELS following PPV vaccination and previous exposure to PPV or pneumococci. 8 , 9 …”

Section: Discussionmentioning

confidence: 99%

Immune system correlates of extensive limb swelling in response to conjugated pneumococcal vaccination

et al. 2018

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Pneumococcal conjugate vaccine (PCV) is recommended for adults with chronic disease. Extensive limb swelling (ELS) is an acute vigorous local inflammatory reaction following vaccination. Predisposing immune system correlates and the influence of ELS on vaccine responses are not known. Here, we report a case of a 67-year-old woman with a history of multiple pneumonias who had a detailed immunological work-up pre-vaccination because of suspected immunodeficiency. Four days following a first vaccination with PCV13 she developed ELS—mimicking erysipelas. Treatment with 20 mg cortisone completely alleviated symptoms within 2 days. Skin biopsy showed a dense dermal and subdermal infiltration dominated by CD4+ T cells and macrophages. In a multiplexed serotype-specific measurement of the anti-pneumococcal IgG response, the patient showed very broad and strong vaccine responses. Pre-vaccination titers were low for the vaccine serotypes. We did not find in vivo nor in vitro evidence of an excessive T cell response to the diphtheria-derived PCV carrier protein. However, we could demonstrate a high antibody titer to a non-vaccine serotype, indicating in vivo pre-exposure to pneumococcus bacteria. Thus, traces of pneumococcal proteins included in PCV13 may have boosted pre-existing pneumococcus-specific T helper cells, which subsequently orchestrated ELS. Our case raises awareness for the risk of vaccine-induced ELS, especially in patients with a history of recurrent pneumococcal disease and thus partial immunity.

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Systemic inflammatory reaction after pneumococcal vaccine

Cited by 15 publications

References 5 publications

Rhesus Macaque Myeloid-Derived Suppressor Cells Demonstrate T Cell Inhibitory Functions and Are Transiently Increased after Vaccination

Rhesus Macaque Myeloid-Derived Suppressor Cells Demonstrate T Cell Inhibitory Functions and Are Transiently Increased after Vaccination

Surveillance and compensation claims for adverse events following immunization from 2011 to 2016 in the Republic of Korea

Immune system correlates of extensive limb swelling in response to conjugated pneumococcal vaccination

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