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Adverse Events of Trivalent Influenza Vaccine among Health Care Workers in Iran (Smoking, female gender risk factors)

Emily

Editor, Senior Moderator
Iranian J Publ Health, Vol. 38, No.2, 2009, pp.51-57
http://ijph.ir/pdfs/6-Dr_Hajabdolbaghi%20RTL!!.pdf
Adverse Events of Trivalent Influenza Vaccine among Health
Care Workers in Iran

Abstract
Background: To assess the frequency and type of adverse events after influenza vaccination in Iranian adults.
Methods: Health care workers in 7 medical centers received the influenza vaccine from October 2006 to February 2007 and
followed by phone regarding symptoms experienced after vaccination.
Results: Of 897 adults who participated in the study, local and systemic reactions were reported by 187 (20.8%) and 198
(22.1%) persons, respectively. The most common local reaction was pain (20.2%), while myalgia (15.8%) was the most
common systemic reaction. One case of Guillain-barre syndrome was reported.
Conclusion: Inactivated influenza vaccine administration did not result in potential adverse events in healthy adults.
Results
Demographic status
A total of 897 healthy HCW were recruited.
Base-line characteristics of the 897 subjects are
listed in Table 1. Fifty-seven percent of vaccinated
subjects (513 persons) were male. The mean
age of the subjects was 35.9?8 (Range 19-58
yr). The mean ages of male and female subjects
were 37.4?7.8 and 33.9?8.0 yr, respectively.
Three hundred and eighty (42.3%) cases had
previous history of influenza vaccination, among
them 41(10.7%) had a previous history of at
least one mild adverse event.
Adverse events
Table 2 shows the adverse events observed in
the subjects who received inactivated influenza
vaccine from October 2006 to February 2007.
Among 897 subjects, 269 (30%) described an
adverse event. Local and systemic reactions were
reported by 187 (20.8%) and 198 (22%) individuals,
respectively. The most common local adverse
reactions to the influenza vaccine were pain
(20.1%), whereas the most common systemic reactions
were myalgia (15.8%). In participants who
experienced pain at the site of injection the duration
of pain alleviation was less than 2 d in
115(63.5%). Seventeen (1.9%) and 28(3.1%) participants

had erythema and induration at the site
of injection for more than 2 d, respectively. Thirteen
(1.4%) participants had a fever over 38.5?
C. Paraplegia was observed in one patient who
managed according to diagnosis of Guillain-Barre
Syndrome.
Table 3 gives the results of the multiple logistic
regression analysis. Gender had a significant effect
on local adverse events (odds ratio= 2.89).
Adverse events were more common in women
than men after adjustment for other factors. Occurrence
of systemic events were influenced by
previous history of vaccination side effects (odds
ratio= 4.01) and smoking (odds ratio= 3.52).
Age did not have an effect on the occurrence of
adverse reactions.

One case of Guillain-Barre Syndrome was reported
following vaccination. He was a 59 yr old
man complained of paresthesia in his lower limbs
9 d after vaccination. He also reported weakness
and respiratory failure which developed within
hours that followed the paresthesia. He was a
smoker. He did not have any history of allergy
and no previous influenza vaccination.
He was
admitted to local hospital, managed according
to diagnosis of Guillain-Barre Syndrome and was
discharged in good condition one month later.
In his hospital admission he also diagnosed as
NIDDM and managed accordingly.
Table 1: Characteristics of the study participants in 7
Medical Centers in Iran, October 2006 to February 2007
Characteristic No. of
participants (%)
Gender
Male 513 (57.1)
Female 384 (42.8)
Occupation
Clerk 777 (86.6)
Worker 78 (8.6)
Others 24 (2.6)
History of smoking 85 (9.4)
History of allergy 89 (9.9)
Previous influenza vaccination 380 (42.3)
Previous vaccination side effects 41 (10.7)
 
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