Vaccine-associated measles in a patient treated with natalizumab: a case report

BMC Infectious Diseases

Vasiliki Pantazou¹  Renaud Du Pasquier¹  Blaise Genton²  Rainer Tan²  Alix Miauton² 

[1] Department of Neurology, Lausanne University Hospital, Bugnon 46, 1011, Lausanne, Switzerland;Tropical, travel and vaccination clinic, Unisanté, Center for primary care and public health, Bugnon 44, 1011, Lausanne, Switzerland;

关键词: Case report;    Measles mumps rubella vaccine;    Measles;    Natalizumab;    Immunosuppression;    Vaccine adverse event;    Multiple sclerosis;    Vaccine;   

DOI  :  10.1186/s12879-020-05475-9

来源: Springer

【 摘 要 】

BackgroundSafety of live vaccines in patients treated with immunosuppressive therapies is not well known, resulting in contradictory vaccination recommendations. We describe here the first case of vaccine-associated measles in a patient on natalizumab treatment.Case presentationA young female patient with relapsing-remitting multiple sclerosis on natalizumab treatment received the live attenuated measles, mumps, and rubella vaccine in preparation for a change in her treatment in favour of fingolimod, with established immunosuppressive qualities. Seven days after receiving the vaccine, our patient experienced diffuse muscle pain, fatigue, and thereafter developed a fever and then an erythematous maculopapular rash, compatible with vaccine associated measles. This was later confirmed by a positive measles RT-PCR throat swab. The patient’s symptoms resolved without any sequelae.ConclusionIn this case report we review the immunosuppressive qualities of natalizumab and the evidence in favour and against live vaccines in patients on this treatment. Our findings reveal the insufficient understanding of the immunosuppressive effects of new immunomodulators, and thus of the safety of live vaccines in patients on such medications. While this case triggers precaution, there is insufficient evidence to conclude that natalizumab treatment could favor the onset of vaccine-associated measles.

【 授权许可】

CC BY