Source: rescuepost.com

 – Introduction: Adverse reactions –  In developed countries, the schedules of

mandatory and recommended vaccination for children contain more and more components with a specific emphasis on the co-

administration of multiple antigens in combined form. This direction

on the one hand provides many benefits and on the other carries an increased risk of side effects, the immunopathogenesis of which is not fully explained in many cases [1].

An adverse event following immunization (AEFI) is an undesirable side effect occurring after the administration of a vaccine [2]. It is a temporary, local or general reaction of the organism to an administered vaccine. A postvaccinal complication (PC) is associated with an excessive or pathological reaction with the characteristics of

post vaccinal disease, which in extreme cases can lead to permanent damage, threat to life or even

death [3]. Complications affecting the nervous system raise the most controversy; the more so, as the children subjected to vaccination are

healthy.

In annex no. 1 to the Ordinance of the Minister of Health of 23rd December 2002 on adverse events following vaccination (Journal of Law from 31/12/2002, no. 241, item 2097, as amended. Journal of Law from 2005, no. 232, item 1973), the following

categories of AEFI are presented [4].

1) Local reactions, including:

a) local reactions after the BCG vaccine,

b) swelling,

c) lymphadenopathy,

d) abscess at the injection site;

2) Postvaccinal adverse events of the central

nervous system:

a) encephalopathy,

b) febrile convulsions,

c) non-febrile convulsions,

d) paralytic poliomyelitis caused by vaccine virus,

e) encephalitis,

f) meningitis,

g)Guillain–Barre syndrome;

3)Other adverse events following immunization:

a) joint pain,

b) hypotonic-hyporesponsive episode

c) fever above 39⁰ C

d) thrombocytopenia,

e) continuous inconsolable crying.

Other classifications of postvaccinal reactions can be found in the literature, some of which put an emphasis on the neurological

symptoms, while others emphasize the immunological mechanisms.

Byers etal. describing neurological complications, have included as “minor”- mild or severe postvaccinal reactions, occurring up to 48

hours after injection and disappearing without leaving permanent sequelae, the following:

prolonged crying, restlessness and hyperactivity, apathy with increased sleepiness, high body temperature, a temporary mild increase in

intracranial pressure manifested by a throbbing crown of the head, “cerebral cry” (sometimes included among “major” complications)

 [5-7].

Among the “major” neurological complications, usually manifesting more than 48 hours after vaccination and which might be the cause of permanent damage to the central nervous system (CNS), the following are listed:

seizures- especially if there is no increase in body temperature, hypotonic-hypo responsive episodes, postvaccinal encephalitis, postvaccinal encephalo-pathy [6,8-11] and autism [10,12-14].

Konior and Strózik [7] have proposed their own classification of postvaccinal reactions taking into account the contribution of the immune system in the vaccinated children. They divided the adverse

events into two groups:

1.related to the immune system – patients with immunodeficiencies (mainly cellular) and atopic patients with hypersensitivity to certain

vaccine components

2.unrelated to the immune system-patients whose post vaccinal reactions may be related to the toxic effects of the vaccine components or may result from the vaccine virus turning

virulent, resulting in complete or abortive symptoms of the disease.

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