Post-marketing safety surveillance for inactivated and live-attenuated Japanese encephalitis vaccines in China, 2008-2013

Vaccine. 2017 Jun 22;35(29):3666-3671. doi: 10.1016/j.vaccine.2017.05.021. Epub 2017 May 25.

Abstract

Introduction: Two types of Japanese encephalitis (JE) vaccines, inactivated JE vaccine (JE-I) and live-attenuated JE vaccine (JE-L), are available and used in China. In particular, one JE-L, produced by a domestic manufacturer in China, was prequalified by WHO in 2013. We assessed the safety of JE vaccines in China during 2008-2013 using the Chinese National Adverse Events Following Immunization Information System (CNAEFIS) data.

Methods: We retrieved AEFI reporting data about JE vaccines from CNAEFIS, 2008-2013, examined demographic characteristics of AEFI cases, and used administrative data on vaccine doses as denominator to calculate and compare crude reporting rates. We also used disproportionality reporting analysis between JE-I and JE-L to assess potential safety signals.

Results: A total of 34,879 AEFIs related with JE-I and JE-L were reported, with a ratio of male to female as 1.3:1; 361 (1.0%) cases were classified as serious. JE vaccines were administered concurrently with one or more other vaccines in 13,592 (39.0%) of cases. The overall AEFI reporting rates were 214.4 per million vaccination doses for JE-L and 176.9 for JE-I (rate ratio [RR]: 1.2, 95% confidence interval [CI]: 1.1-1.3) in 2010-2013. Febrile convulsions (FC) following JE-I was found as a signal of disproportionate reporting (SDR). However, there was no significant difference between the reporting rates of FC of JE-I and JE-L (0.3 per million vaccination doses for JE-L, 0.4 for JE-I, p=0.05).

Conclusions: While our analysis did not find apparent safety concern of JE vaccines in China, further study should consider JE-I vaccines and febrile convulsion, and taking more sensitive methods to detect signals.

Keywords: Adverse events following immunization; China; Disproportionality analysis; Febrile convulsion; Japanese encephalitis vaccine; Surveillance system; Vaccine safety.

MeSH terms

  • Child
  • Child, Preschool
  • China
  • Drug-Related Side Effects and Adverse Reactions / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / pathology
  • Female
  • Humans
  • Infant
  • Japanese Encephalitis Vaccines / administration & dosage
  • Japanese Encephalitis Vaccines / adverse effects*
  • Male
  • Product Surveillance, Postmarketing*
  • Seizures, Febrile / epidemiology
  • Seizures, Febrile / pathology
  • Vaccines, Attenuated / administration & dosage
  • Vaccines, Attenuated / adverse effects
  • Vaccines, Inactivated / administration & dosage
  • Vaccines, Inactivated / adverse effects

Substances

  • Japanese Encephalitis Vaccines
  • Vaccines, Attenuated
  • Vaccines, Inactivated