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      Active pharmacovigilance of the seasonal trivalent influenza vaccine produced by Instituto Butantan: A prospective cohort study of five target groups

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          Abstract

          Introduction

          Active pharmacovigilance studies are pivotal to better characterize vaccine safety.

          Methods

          These are multicenter prospective cohort studies to evaluate the safety of the 2017 and 2018 seasonal trivalent influenza vaccines (TIVs) manufactured by Instituto Butantan, by means of active pharmacovigilance practices. Elderly, children, healthcare workers, pregnant women, and women in the puerperium period were invited to participate in the study during the 2017 and 2018 Brazilian national seasonal influenza vaccination campaigns. Following immunization, participants were observed for 30 minutes and they received a participant card to register adverse events information. All safety information registered were checked at a clinical site visit 14 days after immunization and by a telephone contact 42 days after immunization for unsolicited Adverse Events (AE) and Guillain-Barré Syndrome (GBS).

          Results

          A total of 942 volunteers participated in the two studies: 305 elderly, 109 children, 108 pregnant women, 32 women in the postpartum period, and 388 health workers. Overall, the median number of AR per participant ranged from 1 to 4. The lowest median number of AR per participant was observed among healthcare workers (1 AR per participant) and the highest among pregnant women (4 AR per participant). Overall, local pain (46.6%) was the most frequent solicited local AR. The most frequent systemic ARs were: headache (22.5%) followed by fatigue (16.0%), and malaise (11.0%). The majority of solicited ARs (96%) were mild, Grades 1 or 2), only 3% were Grade 3, and 1% was Grade 4. No serious AEs, including Guillain-Barré Syndrome, were reported up to 42 days postvaccination.

          Conclusion

          The results from the two studies confirmed that the 2017 and 2018 seasonal trivalent influenza vaccines produced by Instituto Butantan were safe and that active pharmacovigilance studies should be considered, when it is feasible, as an important initiative to monitor vaccine safety in the post-marketing period.

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          Most cited references21

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          Estimates of global seasonal influenza-associated respiratory mortality: a modelling study

          Estimates of influenza-associated mortality are important for national and international decision making on public health priorities. Previous estimates of 250 000-500 000 annual influenza deaths are outdated. We updated the estimated number of global annual influenza-associated respiratory deaths using country-specific influenza-associated excess respiratory mortality estimates from 1999-2015.
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            Active SMS-based influenza vaccine safety surveillance in Australian children.

            Australia's novel, active surveillance system, AusVaxSafety, monitors the post-market safety of vaccines in near real time. We analysed cumulative surveillance data for children aged 6 months to 4 years who received seasonal influenza vaccine in 2015 and/or 2016 to determine: adverse event following immunisation (AEFI) rates by vaccine brand, age and concomitant vaccine administration.
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              Is Open Access

              Influenza vaccines: Evaluation of the safety profile

              ABSTRACT The safety of vaccines is a critical factor in maintaining public trust in national vaccination programs. Vaccines are recommended for children, adults and elderly subjects and have to meet higher safety standards, since they are administered to healthy subjects, mainly healthy children. Although vaccines are strictly monitored before authorization, the possibility of adverse events and/or rare adverse events cannot be totally eliminated. Two main types of influenza vaccines are currently available: parenteral inactivated influenza vaccines and intranasal live attenuated vaccines. Both display a good safety profile in adults and children. However, they can cause adverse events and/or rare adverse events, some of which are more prevalent in children, while others with a higher prevalence in adults. The aim of this review is to provide an overview of influenza vaccine safety according to target groups, vaccine types and production methods.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: ValidationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: ValidationRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Formal analysisRole: Funding acquisitionRole: ValidationRole: Writing – original draft
                Role: Data curationRole: InvestigationRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draft
                Role: ConceptualizationRole: Data curationRole: InvestigationRole: Validation
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: Writing – original draft
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: InvestigationRole: Project administrationRole: ResourcesRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Project administrationRole: ResourcesRole: Supervision
                Role: Data curationRole: ResourcesRole: Software
                Role: Data curationRole: InvestigationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: Data curationRole: Formal analysisRole: InvestigationRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: SupervisionRole: Writing – review & editing
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: Funding acquisitionRole: InvestigationRole: Project administrationRole: Writing – original draftRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                11 February 2021
                2021
                : 16
                : 2
                : e0246540
                Affiliations
                [1 ] Clinical Safety and Risk Management Centre, Instituto Butantan, São Paulo, São Paulo, Brazil
                [2 ] Federal University of São Paulo, São Paulo, São Paulo, Brazil
                [3 ] Clinical Trials Centre, Instituto Butantan, São Paulo, São Paulo, Brazil
                [4 ] Oxford University, Oxford, United Kingdom
                [5 ] Federal University of Roraima, Boa Vista, Roraima, Brazil
                [6 ] Center for Vaccine Innovation and Access, Program for Appropriate Technology in Health (PATH), Geneva, Switzerland
                [7 ] Pediatrics Department, Child Institute of the Clinics Hospital of the School of Medicine of University of São Paulo, São Paulo, São Paulo, Brazil
                Public Health England, UNITED KINGDOM
                Author notes

                Competing Interests: TV, MGS, JYKV, RPG, MTRPC, ROP, PEB, AS, HME, JPS, VLG, MEK, MBBL, MMMO, SHDNR, LYW and ARP are employees of Instituto Butantan. BCT and GM are former employees of Instituto Butantan. SHDNR and LYW received financial aid for their roles as principal investigators. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                ‡ These authors also contributed equally to this work

                Author information
                https://orcid.org/0000-0003-0398-9814
                https://orcid.org/0000-0002-4608-8365
                Article
                PONE-D-20-21550
                10.1371/journal.pone.0246540
                7877614
                33571237
                af899c2c-9d5e-44f4-ab5a-641aa7e27b4c
                © 2021 Vanni et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 July 2020
                : 21 January 2021
                Page count
                Figures: 1, Tables: 8, Pages: 17
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/501100005942, Fundação Butantan;
                Award Recipient :
                The study was funded by Instituto Butantan.
                Categories
                Research Article
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Infectious Disease Control
                Vaccines
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Influenza
                Medicine and Health Sciences
                Pharmacology
                Adverse Reactions
                Research and Analysis Methods
                Research Design
                Clinical Research Design
                Adverse Events
                Biology and Life Sciences
                Immunology
                Vaccination and Immunization
                Medicine and Health Sciences
                Immunology
                Vaccination and Immunization
                Medicine and Health Sciences
                Public and Occupational Health
                Preventive Medicine
                Vaccination and Immunization
                Medicine and Health Sciences
                Health Care
                Geriatric Care
                Medicine and Health Sciences
                Pharmacology
                Drug Research and Development
                Drug Safety
                Custom metadata
                All relevant data are within the paper and its Supporting information files.

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