Abstract
From 16 November 2009 to 22 January 2010, Taiwan investigated 23 clusters of mass psychogenic illness after vaccination (MPIV) in the nationwide in-school vaccination programme against the 2009 pandemic influenza A(H1N1). The median age of the 350 ill students (68% female) was 13 years. Intense media coverage of these events has driven public concerns about the safety of the pandemic influenza vaccine. In the future, countries should incorporate surveillance and communication strategies for MPIV in their pandemic preparedness plans.
Highlights
The 2009 pandemic influenza A(H1N1) virus is highly transmissible in schools, and mathematical modelling suggests that vaccinating 70% of schoolchildren could mitigate a pandemic [1]
Enhanced surveillance for mass psychogenic illness after vaccination Each day, starting 23 November 2009, potential clusters of MPIV were retrospectively and prospectively identified through a search of two sources: (i) reports on adverse events following immunisation (AEFI) received by the national passive surveillance system jointly operated by the Taiwan Centers for Disease Control and the Taiwan Food and Drug Administration, and (ii) incident reports received by the Emergency Medical Management System, the Ministry of Health’s web-based system coordinating regional medical resources
Similar outbreaks of MPIV have been reported in school settings [2,4,5], to the best of our knowledge, this report is the first to describe that MPIV could occur as a result of mass introduction of vaccines to adolescents in a pandemic
Summary
The 2009 pandemic influenza A(H1N1) virus is highly transmissible in schools, and mathematical modelling suggests that vaccinating 70% of schoolchildren could mitigate a pandemic [1]. In Taiwan, schoolchildren (first to 12th grade) are among the priority groups to receive the pandemic influenza monovalent vaccine. On 16 November 2009, the government began a nationwide in-school influenza vaccination (NISIV) programme against pandemic influenza, using an inactivated vaccine without adjuvant (Adimmune Corporation, Taichung, Taiwan). On 23 November 2009, the government was notified that within two hours of pandemic influenza vaccination, a cluster of adverse events marked by dizziness, nausea and weakness occurred in 46 (7%) of the 692 schoolchildren aged 12 to 15 years who had received the vaccine at a middle school. Students were transported by ambulance to nearby hospitals and believed the illness was caused by the vaccine. Utilisation data on pandemic influenza vaccines were analysed to assess the impact of MPIV on vaccine coverage among schoolchildren
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