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Volume 7, Number 6—December 2001


Advanced Age a Risk Factor for Illness Temporally Associated with Yellow Fever Vaccination

Michael Martin*†, Leisa H. Weld*, Theodore F. Tsai*, Gina T. Mootrey*, Robert T. Chen*, Manette Niu‡, Martin S. Cetron*, and the GeoSentinel Yellow Fever Working Group
Author affiliations: *Centers for Disease Control and Prevention, Atlanta, Georgia, USA;; †Emory School of Medicine, Atlanta, Georgia, USA;; ‡Center for Biologic Evaluation, U.S. Food and Drug Administration, Rockville, Maryland, USA

Main Article

Table 1

Categories of vaccine adverse eventsa

Neurologic (SyAE)
Guillain-Barré syndrome, new onset seizures, encephalitis, myelitis, altered mental status, focal cranial or peripheral neurologic deficits, paresthesias, vertigo, headaches (headaches alone are not sufficient for neurologic diagnosis)b
Onset <2 weeks after vaccination
Duration >72 hours
Multisystemic (SyAE)
Myalgias, arthralgias, rhabdomyolysis, elevated transaminases, respiratory distress, nausea, vomiting, diarrhea, nephropathy, disseminated intravascular coagulation, +/-feverb
Onset <2 weeks after vaccination
Duration >72 hours
Neurologic/systemic, uncomplicated (OAE)
Cases that met the neurologic or systemic criteria but had a full and rapid clinical recovery in <72 hours
Nonspecific events without other focal finding (OAE)
Dizziness, headache
Nausea, vomiting, or diarrhea alone
Hypersensitivity (OAE)
Rash, urticaria, +/- fever
Anaphylaxis, angioedema
Onset within 48 hours of vaccination
Local reaction (OAE)
Localized pain, swelling, erythema, or warmth (at injection site)
Onset within 1 week of vaccination
Unrelated to vaccine (excluded from AE analysis)
A clear, alternative diagnosis confirmed by laboratory criteria accounts for symptoms and signs; sometimes this is an underlying illness
Another cause implied or stated in the physician's report
For hepatitis A vaccine, onset of adverse event is >6 weeks

aListed in order from most to least severe.
bExamples, but not limited to these signs, symptoms and conditions.
SyAE = systemic adverse event; OAE = other adverse events; AE = adverse event(s).

Main Article

1Jeff Altman, University of Washington, Seattle, Washington; Vernon Ansdell, Kaiser Permanente, Honolulu, Hawaii; Elizabeth Barnett, Boston University, Boston, Massachusetts; Michele Barry Yale University, New Haven, Connecticut; Bradley Connor, Cornell University, New York, New York; David Freedman, University of Alabama at Birmingham, Birmingham, Alabama; Alejandra Gurtman, Mount Sinai Medical Center, New York, New York; Elaine Jong, University of Washington, Seattle, Washington; Phyllis Kozarsky, Emory University, Atlanta, Georgia; Russell McMullen, University of Washington, Seattle, Washington; Jan Patterson, University of Texas, San Antonio, Texas; Bradley Sack, Johns Hopkins University, Baltimore, Maryland; Mary E. Wilson, Harvard University, Cambridge, Massachusetts; Martin Wolfe, Traveler's Medical Service of Washington, Washington, D.C.