title: Overview of the Clinical Consult Case Review of adverse events following immunization: Clinical Immunization Safety Assessment (CISA) network 2004-2009.
abstract: BACKGROUND
  In 2004 the Clinical Consult Case Review (CCCR) working group was formed within the CDC-funded Clinical Immunization Safety Assessment (CISA) Network to review individual cases of adverse events following immunizations (AEFI).
  
  
  METHODS
  Cases were referred by practitioners, health departments, or CDC employees. Vaccine Adverse Event Reporting System (VAERS) searches and literature reviews for similar cases were performed prior to review. After CCCR discussion, AEFI were assessed for a causal relationship with vaccination and recommendations regarding future immunizations were relayed back to the referring physicians. In 2010, surveys were sent to referring physicians to determine the utility and effectiveness of the CCCR service.
  
  
  RESULTS
  CISA investigators reviewed 76 cases during 68 conference calls between April 2004 and December 2009. Almost half of the cases (35/76) were neurological in nature. Similar AEFI for the specific vaccines received were discovered for 63 cases through VAERS searches and for 38 cases through PubMed searches. Causality assessment using the modified WHO criteria resulted in classifying 3 cases as definitely related to vaccine administration, 12 as probably related, 16 as possibly related, 18 as unlikely related, 10 as unrelated, and 17 had insufficient information to assign causality. The physician satisfaction survey was returned by 30 (57.7%) of those surveyed and a majority of respondents (93.3%) felt that the CCCR service was useful.
  
  
  CONCLUSIONS
  The CCCR provides advice about AEFI to practitioners, assigns potential causality, and contributes to an improved understanding of adverse health events following immunizations.
authors.affiliation: Vanderbilt University Medical Center, Nashville, TN, USA. elizabeth.williams@vanderbilt.edu
authors.forename: S Elizabeth
authors.initials: SE
authors.lastname: Williams
authors.forename: Nicola P
authors.initials: NP
authors.lastname: Klein
authors.forename: Neal
authors.initials: N
authors.lastname: Halsey
authors.forename: Cornelia L
authors.initials: CL
authors.lastname: Dekker
authors.forename: Roger P
authors.initials: RP
authors.lastname: Baxter
authors.forename: Colin D
authors.initials: CD
authors.lastname: Marchant
authors.forename: Philip S
authors.initials: PS
authors.lastname: LaRussa
authors.forename: Robert C
authors.initials: RC
authors.lastname: Sparks
authors.forename: Jerome I
authors.initials: JI
authors.lastname: Tokars
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pahud
authors.forename: Laurie
authors.initials: L
authors.lastname: Aukes
authors.forename: Kathleen
authors.initials: K
authors.lastname: Jakob
authors.forename: Silvia
authors.initials: S
authors.lastname: Coronel
authors.forename: Howard
authors.initials: H
authors.lastname: Choi
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Slade
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Edwards
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D016022:Case-Control Studies; D003625:Data Collection / Q000379:methods; D006801:Humans; D007114:Immunization / Q000009:adverse effects*; D012017:Referral and Consultation; D014612:Vaccines / Q000009:adverse effects*
chemical_list: D014612:Vaccines