Febrile illness and bicytopenia within hours after tick-borne encephalitis booster vaccination

Tim Bühler; Noemi Boos; Anne B Leuppi-Taegtmeyer; Christoph T Berger

doi:10.1038/s41541-019-0152-2

Febrile illness and bicytopenia within hours after tick-borne encephalitis booster vaccination

NPJ Vaccines. 2019 Dec 17:4:52. doi: 10.1038/s41541-019-0152-2. eCollection 2019.

Authors

Tim Bühler^{1

2}, Noemi Boos³, Anne B Leuppi-Taegtmeyer¹, Christoph T Berger^{4

5}

Affiliations

¹ 1Department of Clinical Pharmacology & Toxicology, University and University Hospital Basel, Basel, Switzerland.
² 2Regional Center of Pharmacovigilance, University Hospital Basel, Basel, Switzerland.
³ 3Medical Outpatient Clinic, University Hospital Basel, Basel, Switzerland.
⁴ 4Translational Immunology, Department of Biomedicine, University Basel, Basel, Switzerland.
⁵ 5Vaccination Clinic, Medical Outpatient Unit, University Hospital Basel, Basel, Switzerland.

Abstract

We report the case of a 20-year-old male complaining of sudden-onset, severe headaches, fever, chills, and generalized arthralgia. He had no symptoms of a respiratory tract infection. Blood examination revealed severe leukopenia and mild to moderate thrombocytopenia. Onset of symptoms was rapid, intense, and occurred only a few hours after routine tick-borne encephalitis (TBE) booster vaccine. The question of a relationship between booster vaccine administration and the febrile illness with bicytopenia was raised. A broad range of diagnostics excluded infections and other causes for bicytopenia. Symptoms resolved within a few days, and blood counts normalized within two weeks. Due to the close temporal relationship, a transient benign bicytopenia and febrile illness as a systemic reaction to TBE vaccination was assumed. Review of the literature and adverse event reporting systems suggest that this is a very rare reaction.

Keywords: Adjuvants; Fever; Haematological diseases; Inactivated vaccines; Pain.

Publication types

Case Reports