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. 2020 Jan 2;70(2):245-251.
doi: 10.1093/cid/ciz176.

Tick-borne Encephalitis Vaccine Failures: A 10-year Retrospective Study Supporting the Rationale for Adding an Extra Priming Dose in Individuals Starting at Age 50 Years

Karin E Hansson  1   2 , Anja Rosdahl  3   4 , Mona Insulander  5 , Sirkka Vene  6 , Lars Lindquist  7   8 , Sara Gredmark-Russ  1   8 , Helena H Askling  9   10
Affiliations

Tick-borne Encephalitis Vaccine Failures: A 10-year Retrospective Study Supporting the Rationale for Adding an Extra Priming Dose in Individuals Starting at Age 50 Years

Karin E Hansson et al. Clin Infect Dis. .

Abstract

Background: Southern Sweden is endemic for tick-borne encephalitis (TBE), with Stockholm County as one of the high-risk areas. Our aim in 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 Stockholm County during 2006-2015. Vaccine failure was defined as TBE despite adherence to the recommended vaccination schedule with at least 2 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 aged >50 years and 2 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.

Conclusions: To our knowledge, this is the largest documented cohort of TBE vaccine failures. Vaccine failure after 5 TBE vaccine doses is rare. Our data provide rationale for adding an extra priming dose to those aged ≥50 years.

Keywords: TBE; TBEV; vaccination; vaccine failure.

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Figures

Figure 1.
Figure 1.
Definition of a case of tick-borne encephalitis (TBE) vaccine failure.
Figure 2.
Figure 2.
The number of patients who became ill with tick-borne encephalitis regardless of the previous adequate vaccination in Stockholm County, Sweden, 2006–2015. Patients are plotted based on previous number of vaccine doses and their age at the time of disease.
See this image and copyright information in PMC

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