Thursday, March 30, 2017

Vaccine Shedding ! Public Health Officials Know: Recently Vaccinated Individuals can Spread Disease

Hospital Warning about Potential Vaccine Shedding

 St. Jude Patient Guide Informs Parents about Live Virus Vaccine Risk for Immune Compromised Children

CASE OF VACCINE-ASSOCIATED MEASLES FIVE WEEKS POST- IMMUNISATION
http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20649

Characteristics of polio virus strains from long-term excretors with primary immunodeficiencies.
“Individuals who are deficient in humoral immunity are particularly at risk from infection with enteroviruses, and polio virus in particular, where antibodies are the main source of protection from disease. Long-term excretion of vaccine strains of polio virus has been documented for many years and instances of paralytic poliomyelitis in hypogammaglobulinaemic patients who were subsequently found to have been excreting virus for prolonged periods have been reported in the U.S.A., Germany and Japan. The identification of a healthy immunodeficient patient in the U.K. who has probably been excreting type 2 poliovirus for 15 years will be described, with the characteristics of the virus and the results of attempts at treatment so far. Such individuals pose a significant risk to the eradication programme unless they can be identified and treated.”
https://www.ncbi.nlm.nih.gov/m/pubmed/11763340

Chronic progressive poliomyelitis secondary to vaccination of an immunodeficient child.
“We investigated an immunodeficient child in whom chronic progressive poliomyelitis developed after she had received live oral polio virus vaccine. Polio virus, Type II, was isolated from throat and stool during life and from several sites within the brain at autopsy.”
https://www.ncbi.nlm.nih.gov/m/pubmed/195206

Conjugal transfer vaccinia.
“Two cases of conjugal contact transfer vaccinia are described. Each patient had intimate contact after their respective partners, active-duty military personnel, received the smallpox vaccination.”
https://www.ncbi.nlm.nih.gov/m/pubmed/15337993/

Contact transmission of vaccinia virus from smallpox vaccinees in the United States, 2003-2011.
“The vaccine contains live vaccinia virus that can be transferred through physical contact.”
https://www.ncbi.nlm.nih.gov/m/pubmed/22192851/

Detection of fecal shedding of rota virus vaccine in infants following their first dose of pentavalent rota virus vaccine.
https://www.ncbi.nlm.nih.gov/m/pubmed/21477676/

Detection of measles vaccine in the throat of a vaccinated child.
https://www.ncbi.nlm.nih.gov/m/pubmed/11858860/

Detection of measles virus RNA in urine specimens from vaccine recipients.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC228449/

Faecal shedding of canine parvo virus after modified-live vaccination in healthy adult dogs.
“Despite individual differences, CPV DNA was detectable for up to 28 days after vaccination, although the faecal CPV DNA load in these clinically healthy dogs was very low.”
https://www.ncbi.nlm.nih.gov/m/pubmed/28093104/

Herpes zoster due to Oka vaccine strain of varicella zoster virus in an immunosuppressed child post cord blood transplant.
https://www.ncbi.nlm.nih.gov/m/pubmed/17854459

Horizontal transmission of a human rota virus vaccine strain–a randomized, placebo-controlled study in twins.
https://www.ncbi.nlm.nih.gov/m/pubmed/22008819/

Human Illness Associated with Use of Veterinary Vaccines
“Is human exposure to veterinary vaccines a potential public health concern? There is currently limited understanding of the incidence of exposure of individuals to veterinary vaccines or of the consequences of such exposure. In addition, the potential for exposure and for adverse consequences secondary to exposure to veterinary vaccines may be increasing. The increased development and use of veterinary vaccines (including live vaccines), the increased aerosol administration of vaccines, and the increased proportion of individuals in the United States who are immunosuppressed and who may be exposed to these vaccines or to animals shedding the vaccine strains suggest that increased vigilance may be warranted.”
http://m.cid.oxfordjournals.org/content/37/3/407.full

Interference of Vaccine Derived Polio Viruses with Diagnosis of Enteroviral Diseases in Neonatal Period.
“OPV vaccinated neonates commonly pass the vaccine virus in their pharynx and stool which can be mistaken with NPEV.”
https://www.ncbi.nlm.nih.gov/m/pubmed/28050469

Kinetics of polio virus shedding following oral vaccination as measured by quantitative reverse transcription-PCR versus culture.
https://www.ncbi.nlm.nih.gov/m/pubmed/25378579/

Knowledge and attitudes towards influenza vaccination of health care workers in emergency services.
https://www.ncbi.nlm.nih.gov/m/pubmed/27919630/

Long-term viremia and fecal shedding in pups after modified-live canine parvovirus vaccination.
https://www.ncbi.nlm.nih.gov/m/pubmed/24793948/

[Mumps vaccine virus transmission].
“In this work we report the mumps vaccine virus shedding based on the laboratory confirmed cases of the mumps virus (MuV) infection. The likely epidemiological sources of the transmitted mumps virus were children who were recently vaccinated with the mumps vaccine containing Leningrad-Zagreb or Leningrad-3 MuV. The etiology of the described cases of the horizontal transmission of both mumps vaccine viruses was confirmed by PCR with the sequential restriction analysis.”
https://www.ncbi.nlm.nih.gov/m/pubmed/24772647/

Nonfebrile Seizures after Mumps, Measles, Rubella, and Varicella-Zoster Virus Combination Vaccination with Detection of Measles Virus RNA in Serum, Throat, and Urine
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3697452/

Rota virus shedding in premature infants following first immunization.
https://www.ncbi.nlm.nih.gov/m/pubmed/21856359/

Rota virus vaccine-derived shedding and viral reassortants.
https://www.ncbi.nlm.nih.gov/m/pubmed/23249230/

Rota virus vaccines: viral shedding and risk of transmission.
https://www.ncbi.nlm.nih.gov/m/pubmed/18922486/

Rubella persistence in epidermal keratinocytes and granuloma M2 macrophages in patients with primary immunodeficiencies
http://www.jacionline.org/retrieve/pii/S0091674916307126

Serotype-specific mucosal immune response and subsequent poliovirus replication in vaccinated children.
“In the case of poliovirus Type 3, about 10% of children were still excreting the vaccine virus 9 weeks after administering the third dose.”
https://www.ncbi.nlm.nih.gov/m/pubmed/12938203

Spotlight on measles 2010: excretion of vaccine strain measles virus in urine and pharyngeal secretions of a child with vaccine associated febrile rash illness, Croatia, March 2010.
http://www.ncbi.nlm.nih.gov/m/pubmed/20822734/

Spread of vaccinia virus through shaving during military training, Joint Base San Antonio-Lackland, TX, June 2014.
“Adverse events following smallpox vaccination may occur in the vaccinee, in individuals who have contact with the vaccine (i.e., secondary transmission), or in individuals who have contact with the vaccinee’s contact (i.e., tertiary transmission). In June 2014 at Joint Base San Antonio-Lackland, TX, two cases of inadvertent inoculation of vaccinia and one case of a non-viral reaction following vaccination occurred in the security forces training squadron. This includes the first reported case of shaving as the likely source of autoinoculation after contact transmission. This paper describes the diagnosis and treatment of these cases, the outbreak investigation, and steps taken to prevent future transmission.”
https://www.ncbi.nlm.nih.gov/m/pubmed/25162496/

Transmission of imported vaccine-derived polio virus in an undervaccinated community in Minnesota.
https://www.ncbi.nlm.nih.gov/m/pubmed/19090774/

Unintentional transfer of vaccinia virus associated with smallpox vaccines: ACAM2000(®) compared with Dryvax(®).
“We identified 309 reports for ACAM2000® with skin or ocular involvement, of which 93 were autoinoculation cases and 20 were contact transmission cases. The rate for reported cases of autoinoculation was 20.6 per 100,000 vaccinations and for contact transmission was 4.4 per 100,000 vaccinations. Eighteen contact transmission cases could be attributed to contact during a sporting activity (45%) or intimate contact (45%). Of the 113 unintentional transfer cases, 6 met the case definition for ocular vaccinia. The most common locations for all autoinoculation and contact cases were arm/elbow/shoulder (35/113; 31%) and face (24/113; 21%). Methods We reviewed 753 reports associated with smallpox in the Vaccine Adverse Event Reporting System and CDC Pox virus consultation log, reported from March 2008 to August 2010. Reports were classified into categories based upon standard case definitions.”
https://www.ncbi.nlm.nih.gov/m/pubmed/23571177/

Use of a novel real-time PCR assay to detect oral polio vaccine shedding and reversion in stool and sewage samples after a mexican national immunization day.
“During replication, oral polio vaccine (OPV) can revert to neurovirulence and cause paralytic poliomyelitis. In individual vaccinees, it can acquire specific revertant point mutations, leading to vaccine-associated paralytic poliomyelitis (VAPP). With longer replication, OPV can mutate into vaccine-derived poliovirus (VDPV), which causes poliomyelitis outbreaks similar to those caused by wild poliovirus. After wild polio virus eradication, safely phasing out vaccination will likely require global use of inactivated polio vaccine (IPV) until cessation of OPV circulation.”
https://www.ncbi.nlm.nih.gov/m/pubmed/21411577

VACCINE-ASSOCIATED POLIOMYELITIS IN A CHILD WITH THYMIC ABNORMALITY
http://pediatrics.aappublications.org/content/48/6/923

Vaccine-associated poliomyelitis in an infant with agammaglobulinemia.
https://www.ncbi.nlm.nih.gov/m/pubmed/6255734

Varicella Zoster Virus DNA at Inoculation Sites and in Saliva After Zostavax Immunization
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096786/

What is the cause of a rash after measles-mumps-rubella vaccination?
“We describe a 17-month-old child with fever and rash after measles-mumps-rubella vaccination. Detection of vaccine-strain
measles virus in his urine by poly
merase chain reaction confirmed the diagnosis of a vaccine reaction rather than wild-type measles. We propose that measles virus should be sought and identified as vaccine or wild-type virus when the relationship between vaccination and measles-like illness is uncertain.”
https://www.ncbi.nlm.nih.gov/m/pubmed/10494235

REFERENCES:
1. Since this press release was issued the hospital has revised this Patient Guide. These are screen shots of the original, see first two images above. The third image is the redacted version.
2. http://www.stjude.org/stjude/v/index.jsp?vgnextoid=20206f9523e70110VgnVCM1000001e0215acRCRD (This document was taken down since this press release was issued, see image four, above)
3. Outbreak of Measles Among Persons With Prior Evidence of Immunity, New York City, 2011 http://cid.oxfordjournals.org/content/earSince this press release was issued the hospital has revised this page.ly/2014/02/27/cid.ciu105
4. Detection of Measles Virus RNA in Urine Specimens from Vaccine Recipients http://www.ncbi.nlm.nih.gov/pubmed/7494055
5. Comparison of the Safety, Vaccine Virus Shedding and Immunogenicity of Influenza Virus Vaccine, Trivalent, Types A and B, Live Cold-Adapted, Administered to Human Immunodeficiency Virus (HIV)-Infected and Non-HIV Infected Adults http://jid.oxfordjournals.org/content/181/2/725.full
6. Sibling Transmission of Vaccine-Derived Rotavirus (RotaTeq) Associated with Rotavirus Gastroenteritis http://pediatrics.aappublications.org/content/125/2/e438
7. Polio vaccination may continue after wild virus fades http://www.cidrap.umn.edu/news-perspective/2008/10/polio-vaccination-may-continue-after-wild-virus-fades
8. Engineering attenuated virus vaccines by controlling replication fidelity http://www.nature.com/nm/journal/v14/n2/abs/nm1726.html
9. CASE OF VACCINE-ASSOCIATED MEASLES FIVE WEEKS POST-IMMUNISATION, BRITISH COLUMBIA, CANADA, OCTOBER 2013 http://www.eurosurveillance.org/ViewArticle.aspx?ArticleId=20649
10. The Safety Profile of Varicella Vaccine: A 10-Year Review http://jid.oxfordjournals.org/content/197/Supplement_2/S165.full
11. Comparison of Shedding Characteristics of Seasonal Influenza Virus (Sub)Types and Influenza A(H1N1)pdm09; Germany, 2007–2011 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0051653
12. Epigenetics of Host–Pathogen Interactions: The Road Ahead and the Road Behind http://journals.plos.org/plospathogens/article?id=10.1371/journal.ppat.1003007
13. Animal Models for Influenza Virus Pathogenesis and Transmission http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063653/
14. Acellular pertussis vaccines protect against disease but fail to prevent infection and transmission in a nonhuman primate mode http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3063653/
15. Study Finds Parents Can Pass Whooping Cough to Babies http://www.nytimes.com/2007/04/03/health/03coug.html?_r=0
16. Immunized People Getting Whooping Cough http://www.kpbs.org/news/2014/jun/12/immunized-people-getting-whooping-cough/
17. Vaccine Failure — Over 1000 Got Mumps in NY in Last Six Months http://articles.mercola.com/sites/articles/archive/2010/03/06/vaccine-failure–over-1000-get-mumps-in-ny-in-last-six-months.aspx
18. Impact of Repeated Vaccination on Vaccine Effectiveness Against Influenza A(H3N2) and B During 8 Seasons http://cid.oxfordjournals.org/content/early/2014/09/29/cid.ciu680.full
19. http://articles.mercola.com/sites/articles/archive/2012/09/18/flu-shot-increases-flu-illness.aspx
20. http://www.nydailynews.com/new-york/staten-island-dad-22-5m-polio-case-lederle-laboratories-article-1.369105
21. http://naturalsociety.com/woman-contracts-polio-virus-vaccinated-infant/
22. http://www.cdc.gov/mmwr/preview/mmwrhtml/00056803.htm
23. http://vaccineimpact.com/2015/zero-u-s-measles-deaths-in-10-years-but-over-100-measles-vaccine-deaths-reported/

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