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Appendix D Causality Conclusion Tables 673

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TABLE D-1 Causality Conclusions Organized by Chapter and Adverse Event 674 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 4 MMR Measles Inclusion Body Encephalitis Insufficient Strong Convincingly (measles; in individuals Supportsa (in with demonstrated individuals with immunodeficiencies) 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 Inadequate (mumps) Lacking (measles or rubella) 4 MMR Ataxia Insufficient Weak Inadequate (measles or mumps) Lacking (rubella) 4 MMR Autism High (null) Lacking Favors Rejection 4 MMR Acute Disseminated Insufficient Weak Inadequate Encephalomyelitis 4 MMR Transverse Myelitis Insufficient Weak Inadequate

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4 MMR Optic Neuritisb Limited Weak Inadequate 4 MMR Neuromyelitis Opticab Insufficient Weak Inadequate (rubella) 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 Insufficient Lacking Inadequate Polyneuropathy 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) Intermediate Favors Acceptancec (rubella) (rubella) Insufficient Lacking (measles or mumps) (measles or mumps) 4 MMR Transient Arthralgia in Children Moderate (increase) Weak Favors Acceptance (rubella) Lacking (measles or mumps) 675 continued

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TABLE D-1 Continued 676 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 4 MMR Chronic Arthralgia in Women Limited Low-Intermediate Inadequate (rubella) (rubella) Insufficient Lacking (measles or mumps) (measles or mumps) 4 MMR Chronic Arthritis in Women Limited Low-Intermediate Inadequate (rubella) (rubella) Insufficient Lacking (measles or mumps) (measles or mumps) 4 MMR Chronic Arthropathy in Children Insufficient Weak Inadequate (rubella) Lacking (measles or mumps) 4 MMR Arthropathy in Men Limited Weak Inadequate (rubella) 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

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4 MMR Hearing Loss Insufficient Low-Intermediate Inadequate (measles or mumps) Lacking (rubella) 5 Varicella Disseminated Oka VZV without Insufficient Strong Convincingly Supports Other Organ Involvement 5 Varicella Disseminated Oka VZV with Limited Strong Convincingly Supports Subsequent Infection Resulting in (subsequent infection (in individuals (in individuals Pneumonia, Meningitis, or Hepatitis resulting in pneumonia) with demonstrated with demonstrated immunodeficiencies) immunodeficiencies) Insufficient (subsequent infection resulting in meningitis or hepatitis) 5 Varicella Vaccine Strain Viral Reactivation Insufficient Strong Convincingly Supports without Other Organ Involvement 5 Varicella Vaccine Strain Viral Reactivation Limited Strong Convincingly Supports with Subsequent Infection resulting in (subsequent infection Meningitis or Encephalitis resulting in encephalitis) 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 Insufficient Weak Inadequate Encephalomyelitis 677 continued

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TABLE D-1 Continued 678 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 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 Insufficient Weak Inadequate Encephalomyelitis 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 Insufficient Weak Inadequate Polyneuropathy

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6 Influenza Inactivated Influenza Vaccine and High (null) Lacking Favors Rejection Bell’s Palsy 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 High (null) Weak Favors Rejection Asthma Exacerbation or Reactive Airway Disease Episodes in Children and Adults 6 Influenza Live Attenuated Influenza Vaccine Moderate (null) Weak Inadequate or Asthma Exacerbation or Reactive Airway Disease Episodes in Children Younger Than 5 Years of Age 6 Influenza Live Attenuated Influenza Vaccine Moderate (null) Weak Inadequate or Asthma Exacerbation or Reactive Airway Disease Episodes in Persons 5 Years of Age or Older 6 Influenza Onset or Exacerbation of Systemic Limited Lacking Inadequate Lupus Erythematosus (exacerbation) Insufficient (onset) 6 Influenza Onset or Exacerbation of Vasculitis Limited Weak Inadequate (exacerbation) (exacerbation) Insufficient Lacking (onset) (onset) 679 continued

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TABLE D-1 Continued 680 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 6 Influenza Polyarteritis Nodosa Insufficient Lacking Inadequate 6 Influenza Onset or Exacerbation of Insufficient Weak Inadequate Arthropathy 6 Influenza Stroke Moderate Lacking Inadequate (decrease) 6 Influenza Myocardial Infarction Moderate (decrease) Weak Inadequate (Live Attenuated Influenza Vaccine) Lacking (Inactivated Influenza Vaccine) 6 Influenza Fibromyalgia Insufficient Lacking Inadequate 6 Influenza All-Cause Mortalityb Moderate (decrease) Weak Inadequate (Live Attenuated Influenza Vaccine) Lacking (Inactivated Influenza Vaccine) 6 Influenza Oculorespiratory Syndrome Moderate (increase)d Intermediated Favors Acceptanced 7 Hepatitis A Acute Disseminated Insufficient Weak Inadequate Encephalomyelitis 7 Hepatitis A Transverse Myelitis Insufficient Weak Inadequate 7 Hepatitis A Multiple Sclerosis Insufficient Lacking Inadequate

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7 Hepatitis A Guillain-Barré syndrome Insufficient Weak Inadequate 7 Hepatitis A Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 7 Hepatitis A Bell’s Palsy Insufficient Lacking Inadequate 7 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 Insufficient Low-Intermediate Inadequate Encephalomyelitis 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 681 continued

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TABLE D-1 Continued 682 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 8 Hepatitis B Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 8 Hepatitis B Brachial Neuritis Insufficient Lacking Inadequate 8 Hepatitis B Anaphylaxis Insufficient Strong Convincingly Supports (in yeast-sensitive (in yeast-sensitive individuals) individuals) 8 Hepatitis B Erythema Nodosumb Insufficient Weak Inadequate 8 Hepatitis B Onset or Exacerbation of Systemic Limited Weak Inadequate Lupus Erythematosus (onset) Insufficient (exacerbation) 8 Hepatitis B Onset or Exacerbation of Vasculitis Insufficient Low-Intermediate Inadequate 8 Hepatitis B Onset or Exacerbation of Polyarteritis Insufficient Weak Inadequate Nodosa 8 Hepatitis B Onset or Exacerbation of Psoriatic Insufficient Lacking Inadequate Arthritis 8 Hepatitis B Onset or Exacerbation of Reactive Insufficient Weak Inadequate Arthritis 8 Hepatitis B Onset and Exacerbation of Limited Weak Inadequate Rheumatoid Arthritis (exacerbation) Insufficient (onset)

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8 Hepatitis B Onset or Exacerbation of Juvenile Insufficient Weak Inadequate Idiopathic Arthritis 8 Hepatitis B Type 1 Diabetes Moderate (null) Lacking Inadequate 8 Hepatitis B Fibromyalgia Insufficient Lacking Inadequate 9 HPV Acute Disseminated Insufficient Lacking Inadequate Encephalomyelitis 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 Insufficient Lacking Inadequate Polyneuropathy 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 Encephalitis Limited Weak Inadequate containing 10 DT, TT, or aP Encephalopathy Limited Weak Inadequate containing 683 continued

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TABLE D-5 Continued 738 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 4 MMR Transverse Myelitis Insufficient Weak Inadequate 5 Varicella Transverse Myelitis Insufficient Weak Inadequate 6 Influenza Transverse Myelitis Insufficient Weak Inadequate 7 Hepatitis A Transverse Myelitis Insufficient Weak Inadequate 8 Hepatitis B Transverse Myelitis Insufficient Weak Inadequate 4 MMR Optic Neuritisd Limited Weak Inadequate 6 Influenza Optic Neuritisd Limited Weak Inadequate 4 MMR Neuromyelitis Opticad Insufficient Weak Inadequate (rubella) Lacking (measles or mumps) 4 MMR Guillain-Barré syndrome Insufficient Weak Inadequate 5 Varicella Guillain-Barré syndrome Insufficient Weak Inadequate 6 Influenza Guillain-Barré syndrome Moderate (null) Weak Inadequate 7 Hepatitis A Guillain-Barré syndrome Insufficient Weak Inadequate 6 Influenza Chronic Inflammatory Disseminated Insufficient Weak Inadequate Polyneuropathy

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10 DT, TT, or aP Bell’s Palsy Limited Weak Inadequate containing (acellular pertussis) (diphtheria toxoid or tetanus toxoid) Insufficient Lacking (diphtheria toxoid or (acellular pertussis) tetanus toxoid) 7 Hepatitis A Anaphylaxis Insufficient Weak Inadequate 10 DT, TT, or aP Serum Sickness Insufficient Weak Inadequate containing (diphtheria toxoid or tetanus toxoid) Lacking (acellular pertussis) 6 Influenza Inactivated Influenza Vaccine and High (null) Weak Favors Rejection Asthma Exacerbation or Reactive Airway Disease Episodes in Children and Adults 6 Influenza Live Attenuated Influenza Vaccine Moderate (null) Weak Inadequate or Asthma Exacerbation or Reactive Airway Disease Episodes in Children Younger Than 5 Years of Age 6 Influenza Live Attenuated Influenza Vaccine Moderate (null) Weak Inadequate or Asthma Exacerbation or Reactive Airway Disease Episodes in Persons 5 Years of Age or Older 8 Hepatitis B Erythema Nodosumd Insufficient Weak Inadequate 739 continued

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TABLE D-5 Continued 740 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 8 Hepatitis B Onset or Exacerbation of Systemic Limited Weak Inadequate Lupus Erythematosus (onset) Insufficient (exacerbation) 6 Influenza Onset or Exacerbation of Vasculitis Limited Weak Inadequate (exacerbation) (exacerbation) Insufficient Lacking (onset) (onset) 8 Hepatitis B Onset or Exacerbation of Polyarteritis Insufficient Weak Inadequate Nodosa 8 Hepatitis B Onset or Exacerbation of Reactive Insufficient Weak Inadequate Arthritis 8 Hepatitis B Onset and Exacerbation of Limited Weak Inadequate Rheumatoid Arthritis (exacerbation) Insufficient (onset) 8 Hepatitis B Onset or Exacerbation of Juvenile Insufficient Weak Inadequate Idiopathic Arthritis 4 MMR Transient Arthralgia in Children Moderate (increase) Weak Favors Acceptance (rubella) Lacking (measles or mumps)

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4 MMR Chronic Arthropathy in Children Insufficient Weak Inadequate (rubella) Lacking (measles or mumps) 4 MMR Arthropathy in Men Limited Weak Inadequate (rubella) Lacking (measles or mumps) 6 Influenza Onset or Exacerbation of Arthropathy Insufficient Weak Inadequate 7 Hepatitis A Autoimmune Hepatitis Insufficient Weak Inadequate 10 DT, TT, or aP Myocarditis Insufficient Weak Inadequate containing (diphtheria toxoid) Lacking (tetanus toxoid or acellular pertussis) 4 MMR Hepatitis Insufficient Weak Inadequate 5 Varicella Stroked Limited Weak Inadequate 6 Influenza Myocardial Infarction Moderate (decrease) Weak Inadequate (Live Attenuated Influenza Vaccine) Lacking (Inactivated Influenza Vaccine) 741 continued

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TABLE D-5 Continued 742 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 6 Influenza All-Cause Mortalityd Moderate (decrease) Weak Inadequate (Live Attenuated Influenza Vaccine) Lacking (Inactivated Influenza Vaccine) 5 Varicella Thrombocytopenia Insufficient Weak Inadequate 8 Hepatitis B Encephalitis Insufficient Lacking Inadequate 11 Meningococcal Encephalitis Limited Lacking Inadequate 5 Varicella Encephalopathy Insufficient Lacking Inadequate 8 Hepatitis B Encephalopathy Insufficient Lacking Inadequate 11 Meningococcal Encephalopathy Limited Lacking Inadequate 10 DT, TT, or aP Infantile Spasms Limited Lacking Inadequate containing (diphtheria toxoid or tetanus toxoid) Insufficient (acellular pertussis) 4 MMR Afebrile Seizures Limited Lacking Inadequate 6 Influenza Seizuresd Moderate (null) Lacking Inadequate 8 Hepatitis B Seizures Limited Lacking Inadequate 10 DT, TT, or aP Ataxia Insufficient Lacking Inadequate containing

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4 MMR Autism High (null) Lacking Favors Rejection 10 DT, TT, or aP Autism Insufficient Lacking Inadequate containing 9 HPV Acute Disseminated Encephalomyelitis Insufficient Lacking Inadequate 11 Meningococcal Acute Disseminated Encephalomyelitis Insufficient Lacking Inadequate 9 HPV Transverse Myelitis Insufficient Lacking Inadequate 10 DT, TT, or aP Transverse Myelitis Insufficient Lacking Inadequate containing 11 Meningococcal Transverse Myelitis Insufficient Lacking Inadequate 8 Hepatitis B Optic Neuritisd Limited Lacking Inadequate 10 DT, TT, or aP Optic Neuritisd Limited Lacking Inadequate containing (diphtheria toxoid or tetanus toxoid) Insufficient (acellular pertussis) 6 Influenza Neuromyelitis Optica Insufficient Lacking Inadequate 8 Hepatitis B Neuromyelitis Optica Insufficient Lacking Inadequate 9 HPV Neuromyelitis Optica Insufficient Lacking Inadequate 4 MMR Multiple Sclerosis Onset in Adults Limited Lacking Inadequate 6 Influenza Multiple Sclerosis Onset in Adults Limited Lacking Inadequate 8 Hepatitis B Multiple Sclerosis Onset in Adults Limited Lacking Inadequate 743 continued

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TABLE D-5 Continued 744 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 10 DT, TT, or aP Multiple Sclerosis Onset in Adults Limited Lacking Inadequate containing (diphtheria toxoid or tetanus toxoid) Insufficient (acellular pertussis) 4 MMR Multiple Sclerosis Onset in Children Limited Lacking Inadequate 8 Hepatitis B Multiple Sclerosis Onset in Children Limited Lacking Inadequate 6 Influenza Multiple Sclerosis Relapse in Adults Limited Lacking Inadequate 8 Hepatitis B Multiple Sclerosis Relapse in Adults Limited Lacking Inadequate 10 DT, TT, or aP Multiple Sclerosis Relapse in Adults Limited Lacking Inadequate containing (tetanus toxoid) Insufficient (diphtheria toxoid or acellular pertussis) 8 Hepatitis B Multiple Sclerosis Relapse in Children Limited Lacking Inadequate 10 DT, TT, or aP Multiple Sclerosis Relapse in Children Limited Lacking Inadequate containing (diphtheria toxoid or tetanus toxoid) Insufficient (acellular pertussis) 7 Hepatitis A Multiple Sclerosis Insufficient Lacking Inadequate 9 HPV Multiple Sclerosis Insufficient Lacking Inadequate

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11 Meningococcal Multiple Sclerosis Insufficient Lacking Inadequate 8 Hepatitis B First Demyelinating Event in Children Limited Lacking Inadequate 8 Hepatitis B Guillain-Barré syndrome Insufficient Lacking Inadequate 9 HPV Guillain-Barré syndrome Insufficient Lacking Inadequate 10 DT, TT, or aP Guillain-Barré syndrome Insufficient Lacking Inadequate containing 11 Meningococcal Guillain-Barré syndrome Limited Lacking Inadequate 4 MMR Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 7 Hepatitis A Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 8 Hepatitis B Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 9 HPV Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 10 DT, TT, or aP Chronic Inflammatory Disseminated Insufficient Lacking Inadequate containing Polyneuropathy 11 Meningococcal Chronic Inflammatory Disseminated Insufficient Lacking Inadequate Polyneuropathy 4 MMR Opsoclonus Myoclonus Syndrome Insufficient Lacking Inadequate 10 DT, TT, or aP Opsoclonus Myoclonus Syndrome Insufficient Lacking Inadequate containing 6 Influenza Inactivated Influenza Vaccine and Bell’s High (null) Lacking Favors Rejection Palsy 745 continued

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TABLE D-5 Continued 746 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 7 Hepatitis A Bell’s Palsy Insufficient Lacking Inadequate 4 MMR Brachial Neuritis Insufficient Lacking Inadequate 6 Influenza Brachial Neuritis Insufficient Lacking Inadequate 8 Hepatitis B Brachial Neuritis Insufficient Lacking Inadequate 9 HPV Brachial Neuritis Insufficient Lacking Inadequate 9 HPV Amyotrophic Lateral Sclerosis Insufficient Lacking Inadequate 5 Varicella Small Fiber Neuropathyd Insufficient Lacking Inadequate 6 Influenza Small Fiber Neuropathy Insufficient Lacking Inadequate 10 DT and aP Anaphylaxis Insufficient Lacking Inadequate containing 10 DT, TT, or aP Chronic Urticaria Insufficient Lacking Inadequate containing 6 Influenza Onset or Exacerbation of Systemic Limited Lacking Inadequate Lupus Erythematosus (exacerbation) Insufficient (onset) 6 Influenza Polyarteritis Nodosa Insufficient Lacking Inadequate 8 Hepatitis B Onset or Exacerbation of Psoriatic Insufficient Lacking Inadequate Arthritis 9 HPV Transient Arthralgia Limited Lacking Inadequate 5 Varicella Onset or Exacerbation Arthropathy Insufficient Lacking Inadequate

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10 DT, TT, or aP Arthropathy Limited Lacking Inadequate containing (diphtheria toxoid or tetanus toxoid) Insufficient (acellular pertussis) 4 MMR Type 1 Diabetes High (null) Lacking Favors Rejection 8 Hepatitis B Type 1 Diabetes Moderate (null) Lacking Inadequate 10 DT, TT, or aP Type 1 Diabetes High (null) Lacking Favors Rejection containing 9 HPV Pancreatitis Insufficient Lacking Inadequate 9 HPV Thromboembolic Events Insufficient Lacking Inadequate 6 Influenza Stroke Moderate Lacking Inadequate (decrease) 9 HPV Hypercoagulable States Insufficient Lacking Inadequate 4 MMR Chronic Fatigue Syndrome Insufficient Lacking Inadequate 11 Meningococcal Chronic Headache Insufficient Lacking Inadequate 4 MMR Fibromyalgia Insufficient Lacking Inadequate 6 Influenza Fibromyalgia Insufficient Lacking Inadequate 8 Hepatitis B Fibromyalgia Insufficient Lacking Inadequate 10 DT, TT, or aP Fibromyalgia Insufficient Lacking Inadequate containing 10 DT, TT, or aP Sudden Infant Death Syndrome Insufficient Lacking Inadequate containing 747 continued

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TABLE D-5 Continued 748 Epidemiologic Mechanistic Chapter Vaccine Adverse Event Assessment Assessment Causality Conclusion 10 DT, TT, or aP Immune Thrombocytopenic Purpura Insufficient Lacking Inadequate containing NOTE: The measles-mumps-rubella; human papillomavirus; and diphtheria toxoid–, tetanus toxoid–, and acellular pertussis–containing vaccines have been abbreviated in the following ways: MMR; HPV; and DT, TT, and aP containing. a The committee attributes causation to the measles component of the vaccine. b The committee attributes causation to the rubella component of the vaccine. c The committee attributes causation to two particular vaccines used in three particular years in Canada. d Although not originally charged to the committee by the sponsor, the committee considered this adverse event in its review of the literature.