title: Vaccine failures after active immunisation against tick-borne encephalitis.
abstract: Tick-borne encephalitis (TBE) is a major disease of the central nervous system in Europe and is endemic in Sweden with about 200 notified cases annually. The far most effective protective measure against TBE is active immunisation. The vaccines available today induce a high degree of protection in field studies. However, vaccine failures have occasionally been reported and may be overlooked due to different, and sometimes confusing, antibody kinetics in vaccinees with TBEV infection. In this study, 27 patients with clinical and serological evidences of TBE despite adequate immunisation are presented. Vaccination failure is characterized by a slow, and initially non-detectable, development of the specific TBEV-IgM response, seen together with a rapid rise of IgG and neutralising antibodies in serum. The majority (70%) of the patients were more than 50 years of age, which may implicate a need for a modified immunisation strategy in the elderly.
authors.affiliation: Institution of Medicine, Unit for Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden. charlotta.rydgard-andersson@karolinska.se
authors.forename: Charlotta Rydgård
authors.initials: CR
authors.lastname: Andersson
authors.forename: Sirkka
authors.initials: S
authors.lastname: Vene
authors.forename: Mona
authors.initials: M
authors.lastname: Insulander
authors.forename: Lars
authors.initials: L
authors.lastname: Lindquist
authors.forename: Ake
authors.initials: A
authors.lastname: Lundkvist
authors.forename: Göran
authors.initials: G
authors.lastname: Günther
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000818:Animals; D057134:Antibodies, Neutralizing / Q000097:blood; D000914:Antibodies, Viral / Q000097:blood; D002648:Child; D004675:Encephalitis, Tick-Borne / Q000276:immunology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D013548:Sweden; D017211:Treatment Failure; D014765:Viral Vaccines / Q000276:immunology*; D055815:Young Adult
chemical_list: D057134:Antibodies, Neutralizing; D000914:Antibodies, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D014765:Viral Vaccines