Disease |
Organism/Agent |
Neurologic Syndrome(s) |
Vaccine Type(s) |
Representative Vaccine Formulation(s)** |
Indications |
Viral Diseases
|
Influenza |
Single-stranded RNA Orthomyxovirus |
Influenza-associated encephalopathy (rare) |
Inactivated (trivalent inactivated vaccine, TIV) |
TIV, LAIV—various manufacturers; includes most commonly circulating influenza viruses; reformulated seasonally |
TIV, LAIV*: All persons >6 months of age should be vaccinated; when vaccine supply is limited, then high-risk groups should be targeted†
|
Live-attenuated influenza vaccine (LAIV) |
Measles |
Negative-stranded RNA paramyxovirus |
Encephalitis, cerebellitis, aseptic meningitis; subacute sclerosing panencephalitis (SSPE) (rare) |
Live-attenuated |
MMR, MR, M (various manufacturers) |
Routine childhood vaccination (worldwide) |
Immunization of persons without immunity |
Mumps |
Negative-stranded RNA paramyxovirus |
Encephalitis, aseptic meningitis, cerebellitis |
Live-attenuated |
MMR, Mu (various manufacturers) |
Routine childhood vaccinations (worldwide) |
Immunization of persons without immunity |
Rubella |
Positive-stranded RNA Togavirus |
Postinfectious encephalitis; progressive rubella panencephalitis (PRP) (rare); congenital rubella |
Live-attenuated |
MMR, MR, R (various manufacturers) |
Routine childhood vaccination (worldwide) |
Immunization of persons without immunity |
Vaccination of seronegative pregnant women |
Polio |
Positive-stranded RNA picornavirus |
Aseptic meningitis; anterior myelitis producing acute flaccid paralysis (AFP) |
Live-attenuated oral polio vaccine (OPV) |
OPV (various manufacturers) |
IPV: Routine childhood vaccination in children in North America, Europe, Australia, New Zealand¶; booster to adults traveling to polio-endemic countries |
Inactivated intramuscular polio vaccine (IPV) |
IPV (various manufacturers) |
OPV: Routine childhood immunization of children in developing or polio-endemic countries; control of outbreaks; use in national/subnational immunization campaigns |
Rabies |
Negative-stranded RNA rhabdovirus |
Progressive, fatal rhombencephalitis; peripheral neuritis |
Inactivated, nerve-tissue derived (Semple, Fuenzalida); inactivated, purified duck embryo cell derived (PDEV); purified chick embryo cell derived (PCEV); Inactivated, human diploid cell vaccine (HDCV) |
N/A |
Semple, Fuenzalida: Postexposure prophylaxis, only used in Asia, Africa (Semple), and South America (Fuenzalida) |
PDEV, Inactivated Cell Culture: postexposure prophylaxis; preexposure vaccination in high-risk persons (veterinarians, hunters, animal control personnel); preexposure vaccination in travelers to rabies-endemic countries engaging in high-risk activities (eco-tourism, spelunking, etc.) |
Japanese encephalitis |
Positive-stranded RNA flavivirus |
Aseptic meningitis, encephalitis, anterior myelitis |
Inactivated, mouse-brain derived |
N/A |
Vaccination for children in endemic areas |
Inactivated, PHKC-derived |
Vaccination for other susceptible persons in endemic areas |
Live-attenuated, PHKC-derived |
Vaccination for travelers to endemic areas with significant risk of exposure |
Tick-borne encephalitis |
Positive-stranded RNA flavivirus |
Aseptic meningitis, encephalitis, anterior myelitis |
Inactivated, PCEC-derived |
FSME-Immun®‖ (Baxter, Zurich, Switzerland‖; Mississauga, Ontario, Canada) |
Vaccination for children, at-risk persons in endemic areas#
|
Encepur® (Novartis, Basel, Switzerland) |
Vaccination for travelers to endemic areas with significant risk exposure |
Eastern/Western/Venezuelan equine encephalitis |
Positive-stranded RNA togavirus (all) |
Aseptic meningitis, encephalitis |
Inactivated |
Inactivated: VEE TC-83; EEE TSI-GSD-104; WEE TSI-GSD-210 |
Limited use, not available to general public |
Live-attenuated (VEE only) |
Live-attenuated: VEE TC-83 (live) |
Vaccination of military personnel, laboratory workers |
Varicella zoster |
Double-stranded DNA herpesvirus |
Cerebellitis, encephalitis |
Live-attenuated |
MMRV (Proquad®‖, Merck & Co., Inc., Whitehouse Station, NJ), V (various manufacturers) |
Routine childhood vaccination in North America, Europe, Australia, New Zealand |
Immunization of targeted populations (healthcare workers, immunosuppressed) |
Herpes zoster |
Double-stranded DNA herpesvirus |
Latent infection with VZV, resulting in ganglionitis with painful erythematous eruption; post-herpetic neuralgia (PHN) |
Live-attenuated |
Zostavax®‖ (Merck) |
Recommended for persons age 60 and over (U.S.) |
Bacterial Diseases
|
Meningococcus |
Neisseria meningitidis; gram-negative endotoxin-producing diplococcus |
Bacterial meningitis, sepsis |
Polysaccharide vaccines |
Polysaccharide vaccines: Bivalent (serogroups A, C), trivalent (A, C, W135), quadrivalent (A, C, Y, W135) |
U.S., Europe: Recommended for children at 11–12 years of age or at high-school entry |
Conjugate vaccines |
Conjugate vaccines: Monovalent (serogroup C), quadrivalent (A, C, Y, W135) |
Recommended for groups at risk for meningococcal meningitis (college freshmen in dormitories, prisoners, military personnel, laboratory workers) |
|
Control of meningococcal outbreaks |
|
Pneumococcus |
Streptococcus pneumoniae; anaerobic gram-positive diplococcus |
Bacterial meningitis, sepsis |
Polysaccharide vaccines |
Polysaccharide vaccine: various formulations; most commonly used is 23-valent formulation |
Polysaccharide vaccines: Recommended for persons >65 years, and for persons 2–64 years with conditions associated with increased risk of pneumococcal disease (immunocompromised, chronic diseases, asplenia) |
Conjugate vaccines |
Conjugate vaccines: Various formulations; most commonly used is 7-valent formulation |
Conjugate vaccines: Variable by country, but increasingly being incorporated into routine childhood immunization schedule worldwide |
Common protein vaccines (in development) |
|
|
Toxoid Vaccines
|
Tetanus |
Tetanospasmin, a 150kD polypeptide toxin produced by Clostridium tetani, a gram-positive, spore-forming bacillus |
Localized or, more commonly, generalized spasms, hyperreflexia, trismus, autonomic instability |
Inactivated toxoid |
Td‡, DT§, DTP, DTaP (various manufacturers) |
Routine primary childhood vaccination in children 6 weeks-< 7 years in most of the world |
Booster doses every 10 years generally recommended |
Postexposure wound prophylaxis in certain situations |
Diphtheria |
Diphtheria toxin, a 58kD polypeptide exotoxin secreted by Corynebacterium diphtheriae, a gram-positive bacillus |
Palatal and facial paralysis; generalized peripheral neuropathy (uncommon) |
Inactivated toxoid |
Td, DT, DTP, DTaP (various manufacturers) |
Routine primary childhood vaccination in children 6 weeks-<7 years in most of the world |
Booster doses every 10 years generally recommended |
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