Incidence of Adolescent Syncope and Related Injuries Following Vaccination and Routine Venipuncture
- PMID: 38069938
- PMCID: PMC10960660
- DOI: 10.1016/j.jadohealth.2023.11.005
Incidence of Adolescent Syncope and Related Injuries Following Vaccination and Routine Venipuncture
Abstract
Purpose: Vaccination is associated with syncope in adolescents. However, incidence of vaccine-associated syncope and resulting injury, and how it compares to syncope incidence following other medical procedures, is not known. Here, we describe the incidence of syncope and syncope-related injury in adolescents following vaccination and routine venipuncture.
Methods: We identified all Kaiser Permanente Northwest members ages 9-18 years with a vaccination or routine venipuncture and a same-day International Classification of Diseases diagnosis of syncope from 2013 through 2019. All cases were chart reviewed to establish chronology of events (vaccination, venipuncture, syncope, and injury, as applicable) and to attribute cause to vaccination or venipuncture. Incidence rates for vaccine-associated and venipuncture-associated syncope were calculated overall, by sex and age group. Syncope events resulting in injury were assessed for each event type.
Results: Of 197,642 vaccination and 12,246 venipuncture events identified, 549 vaccination and 67 venipuncture events had same-day syncope codes. Chart validation confirmed 59/549 (10.7%) events as vaccine-associated syncope, for a rate of 2.99 per 10,000 vaccination events (95% confidence interval (CI): 2.27-3.85) and 20/67 (29.9%) events as venipuncture-associated syncope, for a rate of 16.33 per 10,000 venipuncture events (95% CI: 9.98-25.21). The incidence rate ratio of vaccine-associated to venipuncture-associated syncope events was 0.18 (95% CI: 0.11-0.31). The incidence of vaccine-associated syncope increased with each additional simultaneously administered vaccine, from 1.51 per 10,000 vaccination events (95% CI: 0.93-2.30) following a single vaccine to 9.94 per 10,000 vaccination events (95% CI: 6.43-14.67) following three or more vaccines. Syncope resulted in injury in about 15% of both vaccine and venipuncture events.
Discussion: Syncope occurs more commonly following venipuncture than vaccination. The number of simultaneously administered vaccines is a risk factor for postvaccination syncope in adolescents.
Keywords: Adolescent preventive medicine; Vaccination; Vasovagal syncope.
Copyright © 2023 Society for Adolescent Health and Medicine. All rights reserved.
Conflict of interest statement
Similar articles
-
Safety of 9-valent human papillomavirus vaccine administered to males and females in routine use.Vaccine. 2023 Mar 10;41(11):1819-1825. doi: 10.1016/j.vaccine.2022.11.009. Epub 2022 Nov 14. Vaccine. 2023. PMID: 36396513
-
Vaccines for preventing typhoid fever.Cochrane Database Syst Rev. 2018 May 31;5(5):CD001261. doi: 10.1002/14651858.CD001261.pub4. Cochrane Database Syst Rev. 2018. PMID: 29851031 Free PMC article. Review.
-
Needle size for vaccination procedures in children and adolescents.Cochrane Database Syst Rev. 2015 Jun 18;(6):CD010720. doi: 10.1002/14651858.CD010720.pub2. Cochrane Database Syst Rev. 2015. Update in: Cochrane Database Syst Rev. 2018 Aug 09;8:CD010720. doi: 10.1002/14651858.CD010720.pub3. PMID: 26086647 Updated. Review.
-
Syncope after vaccination--United States, January 2005-July 2007.MMWR Morb Mortal Wkly Rep. 2008 May 2;57(17):457-60. MMWR Morb Mortal Wkly Rep. 2008. PMID: 18451756
-
Syncope after immunization.Arch Pediatr Adolesc Med. 1997 Mar;151(3):255-9. doi: 10.1001/archpedi.1997.02170400041007. Arch Pediatr Adolesc Med. 1997. PMID: 9080932
References
-
- Ganzeboom KS, Colman N, Reitsma JB, et al. Prevalence and triggers of syncope in medical students. Am J Cardiol 2003;91:1006–8. A8. - PubMed
-
- Woo EJ, Ball R, Braun MM. Fatal syncope-related fall after immunization. Arch Pediatr Adolesc Med 2005;159:1083. - PubMed
-
- Mahajan D, Cook J, Dey A, et al. Supplementary report: Surveillance of adverse events following immunisation among children aged less than seven years in Australia, 1 January to 30 June 2012. Commun Dis Intell Q Rep 2013;37:E130–4. - PubMed
MeSH terms
Substances
Grants and funding
LinkOut - more resources
Full Text Sources
Medical