SE-13

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Adverse Event Definitions & Evaluation

Treatment & Management

Future Doses

Comments

(SE13) Neurologic disease, severe:

Possible diagnoses include:

· Peripheral neuropathy, nonfocal

· Encephalopathy

· Guillain-Barré syndrome

· Progressive focal neurologic disease (see

also SE 14)

Assumes no other etiologic factor

· Consult with neurology for diagnosis and

treatment.

· Some cases may benefit from rapid treatment

with high-dose intravenous immunoglobulin.

· Contact VHC Network for case management

requirements.

· Give temporary exemption, pending

consultation with neurology.

· Submit VAERS report.

· Consider risk for recurrent reaction before

administering additional doses.

· Permanent exemption may be required.

If a patient has " ANY reaction that does not involve the injection

site, " military doctors should, " avoid multiple vaccines in one

session for this patient, " when giving future doses.

Why aren't pediatricians being told this?

Adverse Event Definitions & Evaluation

Treatment & Management

Future Doses

Comments

Systemic Events (SE): Symptoms and signs of illness after

vaccination. Any reaction that does not involve the injection site.

& #61623 Temporal relationship does NOT prove a cause-effect

relationship, particularly if multiple vaccines were given and/or

other specific diagnoses of illness have occurred.

& #61623 Healthcare provider should provide appropriate diagnostic

evaluation.

& #61623 In some cases, give pretreatment to avert symptoms with next

vaccination, to avoid morbidity, but allowing for continued

vaccination.2

& #61623 If mild and self-limited, may proceed with next dose.

& #61623 Avoid multiple vaccines in one session for this patient, if

possible.

& #61623 Privileged healthcare providers may make clinical decisions

to alleviate future discomfort for individual patients who develop

substantial or persistent reactions.7-8

& #61623 VAERS reporting discussed in text.