Nerve damage risk with meningococcal vaccine

Several states are now requiring a vaccine that fights against meningitis to be administered to incoming freshmen in college. Yet, there are reports that this vaccine has been linked to nerve damage. So, what exactly are the risks involved?

As with all vaccines, there can be minor reactions, including pain and redness at the injection site, headache, fatigue or a vague feeling of discomfort, and about half of all people who receive this vaccine will experience these symptoms.

However, like any medicine, there could also possibly be some serious problems, such as severe allergic reactions. These reactions may occur within a few minutes to a few hours of the shot, but the CDC says this is very rare. They also recognize that cases of Guillain-Barré Syndrome, a serious nervous system disorder, have been reported among people who have received Menactra vaccine.

GBS is a serious neurological disorder involving inflammatory demyelination of peripheral nerves. It can occur spontaneously or after certain events such as infections. Illness is typically characterized by the subacute onset of progressive, symmetrical weakness in the legs and arms, with loss of reflexes. Sensory abnormalities, involvement of cranial nerves, and paralysis of respiratory muscles also can occur. A small portion of patients die, and 20% of hospitalized patients can have prolonged disability.

Since 2005 the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA), in partnership with state health departments, are investigating cases of Guillain-Barré syndrome (GBS) among adolescents who recently received the vaccine.

And, according to the CDC and FDA, as of February 25, 2008, more than 15 million doses of Menactra (also known as MCV4) have been distributed, and the Vaccine Adverse Event Reporting System (VAERS) has received 26 confirmed case reports of GBS within 6 weeks of receipt of MCV4 Menactra meningococcal vaccination. Twenty four people, 11 to 19 years of age, experienced symptoms within 6 weeks after receiving Menactra. Two other reports of GBS among people aged 20 years and older also have been confirmed. The symptom onset was 2 to 33 days after vaccination. The timing and onset of neurological symptoms are reasons to gather further information.

According to information found on pubmed.gov, there is data reported in 1990 to 2005 from the VAERS, which is a cooperative program of the Centers for Disease Control and Prevention and the US Food and Drug Administration, where there were 1000 cases (mean age, 47 years) of GBS reported after vaccination in the United States between 1990 and 2005. The onset of GBS was within 6 weeks in 774 cases, less than 6 weeks in 101, and unknown in 125. Death and disability after the event occurred in 32 (3.2%) and 167 (16.7%) subjects, respectively. The highest number of GBS cases was observed in subjects receiving influenza vaccine followed by hepatitis B vaccine. Other vaccines or combinations of vaccines were associated with 274 cases of GBS. The incidence of GBS after influenza vaccination was marginally higher in subjects greater than 65 years compared with those less than or equal to 65 years; for hepatitis vaccine, the incidence was significantly higher in the greater than 65 group. Death was more frequent in subjects less than 65 years compared with those greater than 65 years old.

The results suggest that vaccines other than influenza vaccine can be associated with GBS. Vaccination-related GBS results in death or disability in one fifth of affected individuals, which is comparable to the reported rates in the general GBS population.