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Tick-borne encephalitis (TBE) vaccine failures: A ten-year retrospective study supporting the rationale for adding an extra priming dose in individuals from the age of 50 years
Center for Infectious Medicine, Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden; Department of Infectious diseases, Södersjukhuset, Stockholm, Sweden.
Örebro University, School of Medical Sciences. Department of Infectious Diseases, Örebro University Hospital, Örebro, Sweden.
Department of Communicable Disease Control and Prevention, Stockholm County, Stockholm, Sweden.
Public Health Agency of Sweden, Solna, Sweden.
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2019 (English)In: Clinical Infectious Diseases, ISSN 1058-4838, E-ISSN 1537-6591, article id ciz176Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Southern Sweden is endemic for tick borne encephalitis (TBE), with Stockholm County as one of the high-risk areas. The aim of this study was to describe cases of vaccine failures, and to optimize future vaccination recommendations.

METHODS: Patients with TBE were identified in the notification database at the Department of Communicable Disease Control and Prevention in the county of Stockholm during 2006-2015. Vaccine failure was defined as TBE despite adherence to the recommended vaccination schedule with at least two doses. Clinical data were extracted from medical records.

RESULTS: A total of 1004 TBE cases were identified, 53 (5%) were defined as vaccine failures. In this latter group the median age was 62 years (6-83). Forty-three (81%) patients were over 50 years of age and two were children. Approximately half of the patients had comorbidities with diseases affecting the immune system accounting for 26% of all cases.Vaccine failures following the third or fourth vaccine dose accounted for 36 (68%) of the patients. Severe and moderate TBE disease affected 81% of the cases.

CONCLUSION: To our knowledge, this is the largest documented cohort of TBE-vaccine failures. Vaccine failure after five TBE-vaccine doses is rare. Our data provides rationale for adding an extra priming dose to the age group 50 years and older.

Place, publisher, year, edition, pages
University of Chicago Press, 2019. article id ciz176
Keywords [en]
TBE, TBEV, vaccination, vaccine failure
National Category
Infectious Medicine
Identifiers
URN: urn:nbn:se:oru:diva-73197DOI: 10.1093/cid/ciz176PubMedID: 30843030OAI: oai:DiVA.org:oru-73197DiVA, id: diva2:1297228
Available from: 2019-03-19 Created: 2019-03-19 Last updated: 2019-03-19Bibliographically approved

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Rosdahl, Anja

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