@article{4a0b4ebef4a54015af19505d17f511c0,
title = "Overview of the Clinical Consult Case Review of adverse events following immunization: Clinical Immunization Safety Assessment (CISA) network 2004-2009",
abstract = "Background: In 2004 the Clinical Consult Case Review (CCCR) working group was formed within the CDC-funded Clinical Immunization Safety Assessment (CISA) Network to review individual cases of adverse events following immunizations (AEFI). Methods: Cases were referred by practitioners, health departments, or CDC employees. Vaccine Adverse Event Reporting System (VAERS) searches and literature reviews for similar cases were performed prior to review. After CCCR discussion, AEFI were assessed for a causal relationship with vaccination and recommendations regarding future immunizations were relayed back to the referring physicians. In 2010, surveys were sent to referring physicians to determine the utility and effectiveness of the CCCR service. Results: CISA investigators reviewed 76 cases during 68 conference calls between April 2004 and December 2009. Almost half of the cases (35/76) were neurological in nature. Similar AEFI for the specific vaccines received were discovered for 63 cases through VAERS searches and for 38 cases through PubMed searches. Causality assessment using the modified WHO criteria resulted in classifying 3 cases as definitely related to vaccine administration, 12 as probably related, 16 as possibly related, 18 as unlikely related, 10 as unrelated, and 17 had insufficient information to assign causality. The physician satisfaction survey was returned by 30 (57.7%) of those surveyed and a majority of respondents (93.3%) felt that the CCCR service was useful. Conclusions: The CCCR provides advice about AEFI to practitioners, assigns potential causality, and contributes to an improved understanding of adverse health events following immunizations.",
keywords = "Adverse event following immunization, Causality",
author = "Williams, {S. Elizabeth} and Klein, {Nicola P.} and Neal Halsey and Dekker, {Cornelia L.} and Baxter, {Roger P.} and Marchant, {Colin D.} and LaRussa, {Philip S.} and Sparks, {Robert C.} and Tokars, {Jerome I.} and Pahud, {Barbara A.} and Laurie Aukes and Kathleen Jakob and Silvia Coronel and Howard Choi and Slade, {Barbara A.} and Edwards, {Kathryn M.}",
note = "Funding Information: We would like to acknowledge the contributions of Dr. Mel Berger, Dr. Steve Dreskin, Dr. Peter Donofrio, Dr. Brian McGeeney, Dr. Gerald Fenichel, Susan Swope, Rosanna Setse, Virginia Frontiero and the Vaccine Healthcare Centers Network, including Dr. Jay Montgomery, Dr. Limone Collins and Dr. Renata Engler. This work was supported by the Clinical Immunization and Safety Assessment (CISA) network through a subcontract with America's Health Insurance Plans (AHIP) under contract 200-2002-00732 from the Centers for Disease Control and Prevention (CDC) . Funding Information: Given the positive responses from our survey, it does appear that primary care physicians find the CCCR services beneficial. We believe that the CCCR works well in the academic environment, where the review team can call upon subspecialty experts relatively quickly. However, many providers are not aware of this service and as the CCCR becomes more recognized, it is likely that the demand would increase. Although there are no charges to the providers for this service, 3–4 h of coordinator and investigator time were spent in preparing and scheduling the cases, 1–2 h were spent in discussing the cases, and 1–2 h were spent in providing follow up letters to outline the results and recommendations. This activity was supported through CISA funding. We believe that addressing public concerns about immunizations in an easily accessible format through a systematic process facilitates trust in immunization recommendations, adds to the vaccine safety monitoring infrastructure, and provides a forum where complex adverse events following vaccination can be thoroughly evaluated [55] . ",
year = "2011",
month = sep,
day = "16",
doi = "10.1016/j.vaccine.2011.07.044",
language = "English (US)",
volume = "29",
pages = "6920--6927",
journal = "Vaccine",
issn = "0264-410X",
publisher = "Elsevier BV",
number = "40",
}