Chapter	Vaccine	Adverse Event	Epidemiologic Assessment	Mechanistic Assessment	Causality Conclusion
4	MMR	Measles Inclusion Body Encephalitis	Insufficient	Strong (measles; in individuals with demonstrated immunodeficiencies)	Convincingly Supportsa (in individuals with demonstrated immunodeficiencies)
				Lacking (mumps or rubella)
4	MMR	Encephalitis	Limited	Weak	Inadequate
4	MMR	Encephalopathy	Limited	Weak	Inadequate
4	MMR	Febrile Seizures	High (increase)	Intermediate	Convincingly Supports
4	MMR	Afebrile Seizures	Limited	Lacking	Inadequate
4	MMR	Meningitisb	Moderate (null)	Weak (mumps)	Inadequate
				Lacking (measles or rubella)
4	MMR	Ataxia	Insufficient	Weak (measles or mumps)	Inadequate
				Lacking (rubella)
4	MMR	Autism	High (null)	Lacking	Favors Rejection
4	MMR	Acute Disseminated Encephalomyelitis	Insufficient	Weak	Inadequate
4	MMR	Transverse Myelitis	Insufficient	Weak	Inadequate
4	MMR	Optic Neuritisb	Limited	Weak	Inadequate
4	MMR	Neuromyelitis Opticab	Insufficient	Weak (rubella)	Inadequate
				Lacking (measles or mumps)
4	MMR	Multiple Sclerosis Onset in Adults	Limited	Lacking	Inadequate
4	MMR	Multiple Sclerosis Onset in Children	Limited	Lacking	Inadequate
4	MMR	Guillain-Barré syndrome	Insufficient	Weak	Inadequate
4	MMR	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Lacking	Inadequate
4	MMR	Opsoclonus Myoclonus Syndrome	Insufficient	Lacking	Inadequate
4	MMR	Brachial Neuritis	Insufficient	Lacking	Inadequate
4	MMR	Anaphylaxis	Insufficient	Strong	Convincingly Supports
4	MMR	Transient Arthralgia in Women	Moderate (increase) (rubella)	Intermediate (rubella)	Favors Acceptancec
			Insufficient (measles or mumps)	Lacking (measles or mumps)
4	MMR	Transient Arthralgia in Children	Moderate (increase)	Weak (rubella)	Favors Acceptance
				Lacking (measles or mumps)
4	MMR	Chronic Arthralgia in Women	Limited (rubella)	Low-Intermediate (rubella)	Inadequate
			Insufficient (measles or mumps)	Lacking (measles or mumps)
4	MMR	Chronic Arthritis in Women	Limited (rubella)	Low-Intermediate (rubella)	Inadequate
			Insufficient (measles or mumps)	Lacking (measles or mumps)
4	MMR	Chronic Arthropathy in Children	Insufficient	Weak (rubella)	Inadequate
				Lacking (measles or mumps)
4	MMR	Arthropathy in Men	Limited	Weak (rubella)	Inadequate
				Lacking (measles or mumps)
4	MMR	Type 1 Diabetes	High (null)	Lacking	Favors Rejection
4	MMR	Hepatitis	Insufficient	Weak	Inadequate
4	MMR	Chronic Fatigue Syndrome	Insufficient	Lacking	Inadequate
4	MMR	Fibromyalgia	Insufficient	Lacking	Inadequate
4	MMR	Hearing Loss	Insufficient	Low-Intermediate (measles or mumps)	Inadequate
				Lacking (rubella)
5	Varicella	Disseminated Oka VZV without Other Organ Involvement	Insufficient	Strong	Convincingly Supports
5	Varicella	Disseminated Oka VZV with Subsequent Infection Resulting in Pneumonia, Meningitis, or Hepatitis	Limited (subsequent infection resulting in pneumonia)	Strong (in individuals with demonstrated immunodeficiencies)	Convincingly Supports (in individuals with demonstrated immunodeficiencies)
			Insufficient (subsequent infection resulting in meningitis or hepatitis)
5	Varicella	Vaccine Strain Viral Reactivation without Other Organ Involvement	Insufficient	Strong	Convincingly Supports
5	Varicella	Vaccine Strain Viral Reactivation with Subsequent Infection resulting in Meningitis or Encephalitis	Limited (subsequent infection resulting in encephalitis)	Strong	Convincingly Supports
			Insufficient (subsequent infection resulting in meningitis)
5	Varicella	Encephalopathy	Insufficient	Lacking	Inadequate
5	Varicella	Seizures	Limited	Weak	Inadequate
5	Varicella	Cerebellar Ataxia	Insufficient	Weak	Inadequate
5	Varicella	Acute Disseminated Encephalomyelitis	Insufficient	Weak	Inadequate
5	Varicella	Transverse Myelitis	Insufficient	Weak	Inadequate
5	Varicella	Guillain-Barré syndrome	Insufficient	Weak	Inadequate
5	Varicella	Small Fiber Neuropathyb	Insufficient	Lacking	Inadequate
5	Varicella	Anaphylaxis	Limited	Strong	Convincingly Supports
5	Varicella	Onset or Exacerbation Arthropathy	Insufficient	Lacking	Inadequate
5	Varicella	Strokeb	Limited	Weak	Inadequate
5	Varicella	Thrombocytopenia	Insufficient	Weak	Inadequate
6	Influenza	Encephalitis	Insufficient	Weak	Inadequate
6	Influenza	Encephalopathy	Insufficient	Weak	Inadequate
6	Influenza	Seizuresb	Moderate (null)	Lacking	Inadequate
6	Influenza	Acute Disseminated Encephalomyelitis	Insufficient	Weak	Inadequate
6	Influenza	Transverse Myelitis	Insufficient	Weak	Inadequate
6	Influenza	Optic Neuritisb	Limited	Weak	Inadequate
6	Influenza	Neuromyelitis Optica	Insufficient	Lacking	Inadequate
6	Influenza	Multiple Sclerosis Onset in Adults	Limited	Lacking	Inadequate
6	Influenza	Multiple Sclerosis Relapse in Adults	Limited	Lacking	Inadequate
6	Influenza	Guillain-Barré syndrome	Moderate (null)	Weak	Inadequate
6	Influenza	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Weak	Inadequate
6	Influenza	Inactivated Influenza Vaccine and Bell's Palsy	High (null)	Lacking	Favors Rejection
6	Influenza	Brachial Neuritis	Insufficient	Lacking	Inadequate
6	Influenza	Small Fiber Neuropathy	Insufficient	Lacking	Inadequate
6	Influenza	Anaphylaxis	Limited	Strong	Convincingly Supports
6	Influenza	Inactivated Influenza Vaccine and Asthma Exacerbation or Reactive Airway Disease Episodes in Children and Adults	High (null)	Weak	Favors Rejection
6	Influenza	Live Attenuated Influenza Vaccine or Asthma Exacerbation or Reactive Airway Disease Episodes in Children Younger Than 5 Years of Age	Moderate (null)	Weak	Inadequate
6	Influenza	Live Attenuated Influenza Vaccine or Asthma Exacerbation or Reactive Airway Disease Episodes in Persons 5 Years of Age or Older	Moderate (null)	Weak	Inadequate
6	Influenza	Onset or Exacerbation of Systemic Lupus Erythematosus	Limited (exacerbation)	Lacking	Inadequate
			Insufficient (onset)
6	Influenza	Onset or Exacerbation of Vasculitis	Limited (exacerbation)	Weak (exacerbation)	Inadequate
			Insufficient (onset)	Lacking (onset)
6	Influenza	Polyarteritis Nodosa	Insufficient	Lacking	Inadequate
6	Influenza	Onset or Exacerbation of Arthropathy	Insufficient	Weak	Inadequate
6	Influenza	Stroke	Moderate (decrease)	Lacking	Inadequate
6	Influenza	Myocardial Infarction	Moderate (decrease)	Weak (Live Attenuated Influenza Vaccine)	Inadequate
				Lacking (Inactivated Influenza Vaccine)
6	Influenza	Fibromyalgia	Insufficient	Lacking	Inadequate
6	Influenza	All-Cause Mortalityb	Moderate (decrease)	Weak (Live Attenuated Influenza Vaccine)	Inadequate
				Lacking (Inactivated Influenza Vaccine)
6	Influenza	Oculorespiratory Syndrome	Moderate (increase)d	Intermediated	Favors Acceptanced
	Hepatitis A	Acute Disseminated Encephalomyelitis	Insufficient	Weak	Inadequate
	Hepatitis A	Transverse Myelitis	Insufficient	Weak	Inadequate
7	Hepatitis A	Multiple Sclerosis	Insufficient	Lacking	Inadequate
7	Hepatitis A	Guillain-Barré syndrome	Insufficient	Weak	Inadequate
	Hepatitis A	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Lacking	Inadequate
7	Hepatitis A	Bell's Palsy	Insufficient	Lacking	Inadequate
y	Hepatitis A	Anaphylaxis	Insufficient	Weak	Inadequate
7	Hepatitis A	Autoimmune Hepatitis	Insufficient	Weak	Inadequate
8	Hepatitis B	Encephalitis	Insufficient	Lacking	Inadequate
8	Hepatitis B	Encephalopathy	Insufficient	Lacking	Inadequate
8	Hepatitis B	Seizures	Limited	Lacking	Inadequate
8	Hepatitis B	Acute Disseminated Encephalomyelitis	Insufficient	Low-Intermediate	Inadequate
8	Hepatitis B	Transverse Myelitis	Insufficient	Weak	Inadequate
8	Hepatitis B	Optic Neuritisb	Limited	Lacking	Inadequate
8	Hepatitis B	Neuromyelitis Optica	Insufficient	Lacking	Inadequate
8	Hepatitis B	Multiple Sclerosis Onset in Adults	Limited	Lacking	Inadequate
8	Hepatitis B	Multiple Sclerosis Onset in Children	Limited	Lacking	Inadequate
8	Hepatitis B	Multiple Sclerosis Relapse in Adults	Limited	Lacking	Inadequate
8	Hepatitis B	Multiple Sclerosis Relapse in Children	Limited	Lacking	Inadequate
8	Hepatitis B	First Demyelinating Event in Adults	Moderate (null)	Low-Intermediate	Inadequate
8	Hepatitis B	First Demyelinating Event in Children	Limited	Lacking	Inadequate
8	Hepatitis B	Guillain-Barré syndrome	Insufficient	Lacking	Inadequate
8	Hepatitis B	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Lacking	Inadequate
8	Hepatitis B	Brachial Neuritis	Insufficient	Lacking	Inadequate
8	Hepatitis B	Anaphylaxis	Insufficient	Strong (in yeast-sensitive individuals)	Convincingly Supports (in yeast-sensitive individuals)
8	Hepatitis B	Erythema Nodosumb	Insufficient	Weak	Inadequate
8	Hepatitis B	Onset or Exacerbation of Systemic Lupus Erythematosus	Limited (onset)	Weak	Inadequate
			Insufficient (exacerbation)
8	Hepatitis B	Onset or Exacerbation of Vasculitis	Insufficient	Low-Intermediate	Inadequate
8	Hepatitis B	Onset or Exacerbation of Polyarteritis Nodosa	Insufficient	Weak	Inadequate
8	Hepatitis B	Onset or Exacerbation of Psoriatic Arthritis	Insufficient	Lacking	Inadequate
8	Hepatitis B	Onset or Exacerbation of Reactive Arthritis	Insufficient	Weak	Inadequate
8	Hepatitis B	Onset and Exacerbation of Rheumatoid Arthritis	Limited (exacerbation)	Weak	Inadequate
			Insufficient (onset)
8	Hepatitis B	Onset or Exacerbation of Juvenile Idiopathic Arthritis	Insufficient	Weak	Inadequate
8	Hepatitis B	Type 1 Diabetes	Moderate (null)	Lacking	Inadequate
8	Hepatitis B	Fibromyalgia	Insufficient	Lacking	Inadequate
9	HPV	Acute Disseminated Encephalomyelitis	Insufficient	Lacking	Inadequate
9	HPV	Transverse Myelitis	Insufficient	Lacking	Inadequate
9	HPV	Neuromyelitis Optica	Insufficient	Lacking	Inadequate
9	HPV	Multiple Sclerosis	Insufficient	Lacking	Inadequate
9	HPV	Guillain-Barré syndrome	Insufficient	Lacking	Inadequate
9	HPV	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Lacking	Inadequate
9	HPV	Brachial Neuritis	Insufficient	Lacking	Inadequate
9	HPV	Amyotrophic Lateral Sclerosis	Insufficient	Lacking	Inadequate
9	HPV	Anaphylaxis	Insufficient	Intermediate	Favors Acceptance
9	HPV	Transient Arthralgia	Limited	Lacking	Inadequate
9	HPV	Pancreatitis	Insufficient	Lacking	Inadequate
9	HPV	Thromboembolic Events	Insufficient	Lacking	Inadequate
9	HPV	Hypercoagulable States	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Encephalitis	Limited	Weak	Inadequate
10	DT, TT, or aP containing	Encephalopathy	Limited	Weak	Inadequate
10	DT, TT, or aP containing	Infantile Spasms	Limited (diphtheria toxoid or tetanus toxoid)	Lacking	Inadequate
			Insufficient (acellular pertussis)
10	DT, TT, or aP containing	Seizures	Limited	III	Inadequate
10	DT, TT, or aP containing	Ataxia	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Autism	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Acute Disseminated Encephalomyelitis	Insufficient	Weak (tetanus toxoid)	Inadequate
				Lacking (diphtheria toxoid or acellular pertussis)
10	DT, TT, or aP containing	Transverse Myelitis	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Optic Neuritisb	Limited (diphtheria toxoid or tetanus toxoid)	Lacking	Inadequate
			Insufficient (acellular pertussis)
10	DT, TT, or aP containing	Multiple Sclerosis Onset in Adults	Limited (diphtheria toxoid or tetanus toxoid)	Lacking	Inadequate
			Insufficient (acellular pertussis)
10	DT, TT, or aP containing	Multiple Sclerosis Relapse in Adults	Limited (tetanus toxoid)	Lacking	Inadequate
			Insufficient (diphtheria toxoid or acellular pertussis)
10	DT, TT, or aP containing	Multiple Sclerosis Relapse in Children	Limited (diphtheria toxoid or tetanus toxoid)	Lacking	Inadequate
			Insufficient (acellular pertussis)
10	DT, TT, or aP containing	Guillain-Barré syndrome	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Opsoclonus Myoclonus Syndrome	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Bell's Palsy	Limited (acel hilar pertussis)	Weak (diphtheria toxoid or tetanus toxoid)	Inadequate
			Insufficient (diphtheria toxoid or tetanus toxoid)	Lacking (acellular pertussis)
10	TT containing	Anaphylaxis	Insufficient	Strong	Convincingly Supports
10	DT and aP containing	Anaphylaxis	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Chronic Urticaria	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Serum Sickness	Insufficient	Weak (diphtheria toxoid or tetanus toxoid)	Inadequate
				Lacking (acellular pertussis)
10	DT, TT, or aP containing	Arthropathy	Limited (diphtheria toxoid or tetanus toxoid)	Lacking	Inadequate
			Insufficient (acellular pertussis)
10	DT, TT, or aP containing	Type 1 Diabetes	High (null)	Lacking	Favors Rejection
10	DT, TT, or aP containing	Myocarditis	Insufficient	Weak (diphtheria toxoid)	Inadequate
				Lacking (tetanus toxoid or acellular pertussis)
10	DT, TT, or aP containing	Fibromyalgia	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Sudden Infant Death Syndrome	Insufficient	Lacking	Inadequate
10	DT, TT, or aP containing	Immune Thrombocytopenic Purpura	Insufficient	Lacking	Inadequate
11	Meningococcal	Encephalitis	Limited	Lacking	Inadequate
11	Meningococcal	Encephalopathy	Limited	Lacking	Inadequate
11	Meningococcal	Acute Disseminated Encephalomyelitis	Insufficient	Lacking	Inadequate
11	Meningococcal	Transverse Myelitis	Insufficient	Lacking	Inadequate
11	Meningococcal	Multiple Sclerosis	Insufficient	Lacking	Inadequate
11	Meningococcal	Guillain-Barré syndrome	Limited	Lacking	Inadequate
11	Meningococcal	Chronic Inflammatory Disseminated Polyneuropathy	Insufficient	Lacking	Inadequate
11	Meningococcal	Anaphylaxis	Insufficient	Strong	Convincingly Supports
11	Meningococcal	Chronic Headache	Insufficient	Lacking	Inadequate
12	Injection-Related Event	Complex Regional Pain Syndrome	Insufficient	Low-Intermediate	Inadequate
12	Injection-Related Event	Deltoid Bursitis	Limited	Strong	Convincingly Supports
12	Injection-Related Event	Syncope	Insufficient	Strong	Convincingly Supports