title: Impact of unfounded vaccine safety concerns on the nationwide measles-rubella immunization campaign, Georgia, 2008.
abstract: Vaccine safety fears following media reports of adverse events led to low (50.3%) coverage in a supplementary measles-rubella immunization campaign in Georgia in 2008. Review of adverse events associated with the campaign identified 432 reports (<0.1% of ∼ 493,000 vaccinees) including 338 (78.2%) cases of syncope. There were no deaths. Causality assessment was performed for 79 cases perceived by providers as severe and with clinical details available. Conditions likely caused by the vaccine were identified in 13 (16.5%) cases (allergic and local reactions, thrombocytopenia). Thirty-seven (46.8%) cases had symptoms consistent with syncope or anxiety attack; 36 (97.3%) of them were initially misdiagnosed as anaphylactic shock/allergies/"postvaccinal reactions". Twenty-nine (36.7%) cases had coincidental illnesses. Safety fears were unfounded and exaggerated by media reports and providers' difficulties in recognizing syncope/anxiety attacks. Risk communication strategies to address perceived vaccine safety concerns are urgently needed to ensure that the goal of measles and rubella elimination in the European Region of the World Health Organization is met.
authors.affiliation: CDC, National Center for Immunization and Respiratory Diseases, Global Immunization Division, 1600 Clifton Rd, MS-E05 Atlanta, GA, USA. nck7@cdc.gov
authors.forename: N
authors.initials: N
authors.lastname: Khetsuriani
authors.forename: P
authors.initials: P
authors.lastname: Imnadze
authors.forename: L
authors.initials: L
authors.lastname: Baidoshvili
authors.forename: L
authors.initials: L
authors.lastname: Jabidze
authors.forename: N
authors.initials: N
authors.lastname: Tatishili
authors.forename: G
authors.initials: G
authors.lastname: Kurtsikashvili
authors.forename: T
authors.initials: T
authors.lastname: Lezhava
authors.forename: E
authors.initials: E
authors.lastname: Laurent
authors.forename: R
authors.initials: R
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D016907:Adverse Drug Reaction Reporting Systems; D000707:Anaphylaxis / Q000139:chemically induced / Q000453:epidemiology; D002648:Child; D005846:Georgia (Republic) / Q000453:epidemiology; D006801:Humans; D017589:Immunization Programs; D015994:Incidence; D008457:Measles / Q000453:epidemiology / Q000517:prevention & control*; D008458:Measles Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D012409:Rubella / Q000453:epidemiology / Q000517:prevention & control*; D012411:Rubella Vaccine / Q000008:administration & dosage / Q000009:adverse effects*; D013575:Syncope / Q000139:chemically induced / Q000453:epidemiology; D055815:Young Adult
chemical_list: D008458:Measles Vaccine; D012411:Rubella Vaccine