Center for Biologics Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Ave., Silver Spring, MD 20993, United States.
Immunization Safety Office, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, United States.
Vaccine. 2022 Jan 21;40(2):247-254. doi: 10.1016/j.vaccine.2021.11.071. Epub 2021 Dec 7.
Bexsero® (GlaxoSmithKline) is a four-component Neisseria meningitidis serogroup B vaccine (MenB-4C). It was licensed in the United States in 2015 for use among individuals ages 10-25 years. We aimed to assess the post-licensure safety profile of MenB-4C by examining reports received in the Vaccine Adverse Event Reporting System (VAERS).
VAERS is a national passive surveillance system for adverse events (AEs) following immunization that uses the Medical Dictionary for Regulatory Activities to code reported AEs and the Code of Federal Regulations to classify reports by seriousness. In this case series, we analyzed U.S. reports involving MenB-4C received between January 23, 2015 through December 31, 2018. We used Empirical Bayesian data mining to identify MenB-4C/AE combinations reported at least twice as often as expected.
VAERS received 1,867 reports following MenB-4C administration, representing 332 reports per million doses distributed. Most reports were for females (59%), with a median age of 17 years (interquartile range: 16-18 years); 40% of reports described simultaneous administration of other vaccines. The majority of reports were classified as non-serious (96%). The most commonly reported AEs were injection site pain (22%), pyrexia (16%), and headache (16%). Data mining identified disproportionate reporting for "injected limb mobility decreased" secondary to injection site reactions, including extensive swelling of the vaccinated limb and injection site pain.
Analysis of passive surveillance data from over 5.6 million doses of MenB-4C distributed in the United States did not reveal new safety concerns. The large majority of reports were classified as non-serious and the reported AEs were generally consistent with the safety experience described in clinical studies and the product's package insert. While our results are reassuring, continued post-marketing surveillance is warranted.
Bexsero®(葛兰素史克)是一种四组分脑膜炎奈瑟菌 B 群疫苗(MenB-4C)。它于 2015 年在美国获得许可,用于 10-25 岁人群。我们旨在通过检查疫苗不良事件报告系统(VAERS)中收到的报告来评估 MenB-4C 的上市后安全性。
VAERS 是一个用于接种疫苗后不良事件(AE)的全国性被动监测系统,使用监管活动医学词典对报告的 AE 进行编码,并使用《联邦法规》对报告进行严重性分类。在本病例系列中,我们分析了 2015 年 1 月 23 日至 2018 年 12 月 31 日期间在美国收到的涉及 MenB-4C 的报告。我们使用经验贝叶斯数据挖掘来识别报告次数至少是预期两倍的 MenB-4C/AE 组合。
VAERS 收到了 1867 份 MenB-4C 接种后的报告,代表每百万剂分布 332 份报告。大多数报告是女性(59%),中位数年龄为 17 岁(四分位间距:16-18 岁);40%的报告描述了同时接种其他疫苗。大多数报告被归类为非严重(96%)。最常报告的 AE 是注射部位疼痛(22%)、发热(16%)和头痛(16%)。数据挖掘发现,由于注射部位反应,“注射肢体活动度降低”的报告比例不成比例,包括接种肢体广泛肿胀和注射部位疼痛。
对美国超过 560 万剂 MenB-4C 分布的被动监测数据进行分析未发现新的安全性问题。绝大多数报告被归类为非严重,报告的 AE 通常与临床试验和产品说明书中描述的安全性经验一致。虽然我们的结果令人安心,但仍需要进行上市后监测。