Received Jun 1, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| MMR | MEASLES + MUMPS + RUBELLA (NO BRAND NAME) | UNKNOWN MANUFACTURER | UNK | UNK | — |
measles vaccine-associated pneumonia; acute hypoxic respiratory failure; encephalopathy; This serious case was reported in a literature article and described the occurrence of viral pneumonia in a 76-year-old female patient who received MMR (MMR vaccine) solution for injection for prophylaxis. Literature Reference. The patient's past medical history included autologous hematopoietic stem cell transplant (10 years previously) and chimeric antigen receptor t-cell therapy (2 years previously). Previously administered products included trimethoprim/sulfamethoxazole with an associated reaction of adverse drug reaction. Concurrent medical conditions included multiple myeloma, evans syndrome, anemia, lymphopenia, hypogammaglobulinemia, immunocompromised and coronavirus infection. Concomitant products included typhoid vaccine polysacch vi (Vi Polysaccharide Typhoid Vaccine), daratumumab, immunoglobulins and prednisone. On an unknown date, the patient received MMR vaccine. On an unknown date, less than a month after receiving MMR vaccine, the patient experienced viral pneumonia (Verbatim: measles vaccine-associated pneumonia) (serious criteria death, hospitalization and GSK medically significant), acute hypoxic respiratory failure (Verbatim: acute hypoxic respiratory failure) (serious criteria death, hospitalization and GSK medically significant) and encephalopathy (Verbatim: encephalopathy) (serious criteria death, hospitalization and GSK medically significant). The patient was treated with cefepime, azithromycin, aciclovir (Acyclovir), atovaquone, posaconazole, vitamin A nos, ribavirin, meropenem, clindamycin, immunoglobulins and oxygen. The reported cause of death was viral pneumonia, acute hypoxic respiratory failure and encephalopathy. The reporter considered the viral pneumonia, acute hypoxic respiratory failure and encephalopathy to be related to MMR vaccine. The company considered the viral pneumonia, acute hypoxic respiratory failure and encephalopathy to be unrelated to MMR vaccine. Additional Information: GSK receipt date: 25-MAY-2026 Author reported a patient with a medical history significant for stage 3 multiple myeloma was transferred from the clinic to the inpatient service following concern for acute hypoxic respiratory failure and failure to thrive. The patient had received multiple lines of myeloma treatment, including autologous HSCT 10 years previously and chimeric antigen receptor T-cell therapy 2 years previously. Additionally, patient had received daratumumab 2 months (day -57) before admission and was currently on intravenous immunoglobulin (IVIG) and prednisone therapy for Evans syndrome. Three weeks (day -19) before admission to institution, the patient presented to an outside emergency department and was treated for suspected community-acquired pneumonia after a computed tomography of the chest demonstrated left lower lobe consolidation. On admission to institution (day 0), the patient endorsed extreme fatigue and shortness of breath requiring supplemental oxygen. Patient noted mild clinical improvement following the antibiotic course. At rest, patient vital signs were within normal ranges, but upon exertion, patient was tachypneic, hypoxemic, and required oxygen supplementation. Initial testing for infectious etiologies was significant for a nasopharyngeal swab positive for seasonal coronavirus (HCoV) OC43 via multiplex syndromic respiratory panel, indeterminate serum (1,3)-beta-D-glucan, negative nasal MRSA PCR, and negative urine pneumococcal antigen. Additional infectious workup was negative, including blood, respiratory, acid-fast bacillus, and fungal cultures; serum Aspergillus galacto mannan; Legionella pneumophila urinary antigen; Mucorales PCR; Coccidioides IgG/IgM with immunodiffusion and complement fixation; cryptococcal antigen; and quantitative cytomegalovirus (CMV) and Epstein-Barr virus PCR. Chest CT demonstrated extensive bronchovascular ground-glass opacities and consolidation consistent with multifocal pneumonia. Other relevant findings included anemia (Hgb 9.8 g/dL, reference: 13.0 17.0 g/dL) with severe lymphopenia (30 cells/uL; 0.3 percent, reference: 1.30-3.60 k/uL and 17.6 percent -49.6 percent) and hypogammaglobulinemia (IgG 279 mg/dL; reference: 768-1,632 mg/ dL). The patient received cefepime and azithromycin for empirical bacterial pneumonia coverage and acyclovir for CMV prophylaxis. Given a concern for atypical and opportunistic infections, the patient was also started on atovaquone for pneumocystis coverage due to a prior reaction to trimethoprim/sulfamethoxazole and fungal treatment with posaconazole. Upon further questioning, the patient reported receiving the MMR and typhoid polysaccharide vaccines in preparation for a trip to Africa approximately 1 month (day -36) before admission. Notably, patient IgG was 123 mg/dL on the day of vaccination, and patient had just decreased patient prednisone taper from 20 to 10 mg/day. Due to the potential for measles vaccine-associated pneumonia, a nasopharyngeal swab was submitted for measles PCR testing at institution using a laboratory-developed test that includes a vaccine-specific measles target (6). A positive measles virus vaccine strain detection (MeV-pan measles Ct: 30.4, MeVA-vaccine Ct: 30.6) was reported on hospital day 4. Subsequently, the patient started on IVIG, vitamin A, and ribavirin. The patient was also switched to meropenem and clindamycin due to concern of superimposed bacterial pneumonia secondary to viral pneumonia. Two days later (day 6), the patient was transferred to the ICU due to increased oxygen requirements. A bronchoalveolar lavage performed on the previous day (day 5) detected both seasonal coronavirus via multiplex syndromic pneumonia panel and measles virus vaccine strain (MeV-pan measles Ct: 33.4, MeVA-vaccine Ct: 33.0). Cytology of the BAL was notable for scattered multinucleated giant cells compatible with viral pneumonia. Other BAL studies were negative, including bacterial, fungal, Nocardia, and AFB cultures; Legion ella PCR; Coccidioides PCR; Histoplasma/Blastomyces PCR; Aspergillus PCR; Aspergillus galactomannan; and Pneumocystis jirovecii PCR. Additional negative infectious studies included Coccidioides serologies, cryptococcal antigen, and urine Legionella antigen. Despite broad-spectrum therapy, the patient continued to decline and was intubated on day 7. A repeat chest CT was notable for worsening multifocal infection. After progressive weakness and encephalopathy, the patient was transitioned to comfort care and succumbed to patient illness on day 16. In this case report, describe an immunocompromised individual who developed severe pneumonia with both HCoV and measles virus vaccine strain detected by PCR in a BAL specimen. This case highlights the rare but severe complication of measles vaccine associated pneumonia in an immunocompromised host. This article corresponding to this case was not available for regulatory submission due to copyright restriction.; Sender's Comments: A case of Pneumonia viral, Acute respiratory failure, Encephalopathy, unknown time after receiving MMR vaccine in a 76-year-old female patient. Report is inconsistent with causal relation to the vaccine product, considering absence of biological plausibility and alternative risk factors (concurrent multiple myeloma, anemia, lymphopenia, imunocompromised, evans syndrome and coronavirus infection).; Reported Cause(s) of Death: measles vaccine-associated pneumonia; Acute hypoxic respiratory failure; encephalopathy
Anemia; Coronavirus infection; Evans syndrome; Hypogammaglobulinemia; Immunocompromised; Lymphopenia; Multiple myeloma
Medical History/Concurrent Conditions: Autologous hematopoietic stem cell transplant (10 years previously); Chimeric antigen receptor T-cell therapy (2 years previously)
VI POLYSACCHARIDE TYPHOID VACCINE; DARATUMUMAB; IMMUNOGLOBULINS; PREDNISONE
Test Name: serum Aspergillus galactomannan test; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: Histoplasma/Blastomyces PCR; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Name: gammaglobulin; Test Result: 279 mg/dl; Test Name: gammaglobulin; Test Result: 123 mg/dl; Test Name: blood test; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: other bronchoalveolar lavage; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Name: Coccidioides PCR; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Name: computed tomography of the chest; Result Unstructured Data: (Test Result:left lower lobe consolidation,Unit:unknown,Normal Low:,Normal High:); Test Name: cryptococcal antigen; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: quantitative cytomegalovirus; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: Epstein-Barr virus PCR; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: fungal cultures; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: Hgb; Result Unstructured Data: (Test Result:9.8,Unit:g/dL,Normal Low:13,Normal High:17) anemia; Test Name: Histoplasma/Blastomyces PCR; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Name: Legionella PCR; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Name: Legionella pneumophila urinary antigen; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: lymphocyte; Result Unstructured Data: (Test Result:30 cells/uL; 0.3 percent,Unit:K/uL,Normal Low:1.30,Normal High:3.60) lymphopenia (ref: 17.6 percent - 49.6 percent); Test Name: acid-fast bacillus; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: nasopharyngeal swab; Result Unstructured Data: (Test Result:positive for seasonal coronavirus (HCoV),Unit:unknown,Normal Low:,Normal High:); Test Name: blood oxygen; Result Unstructured Data: (Test Result:low,Unit:unknown,Normal Low:,Normal High:) hypoxemic; Test Name: Pneumocystis jirovecii PCR; Result Unstructured Data: (Test Result:negative,Unit:unknown,Normal Low:,Normal High:); Test Name: breath; Result Unstructured Data: (Test Result:elevated,Unit:unknown,Normal Low:,Normal High:) tachypneic; Test Name: respiratory test; Result Unstructured Data: (Test Result:was negative for infection,Unit:unknown,Normal Low:,Normal High:); Test Name: vital signs; Result Unstructured Data: (Test Result:within normal ranges,Unit:unknown,Normal Low:,Normal High:) At rest; Test Name: vital signs; Result Unstructured Data: (Test Result:tachypneic, hypoxemic,Unit:unknown,Normal Low:,Normal High:) upon exertion; Comments: On an unknown date, Initial testing for infectious etiologies was significant for a nasopharyngeal swab positive for seasonal coronavirus (HCoV) OC43 via multiplex syndromic respiratory panel, indeterminate serum (1,3)-beta-D-glucan, negative nasal MRSA PCR, and negative urine pneumococcal antigen. Mucorales PCR; Coccidioides IgG/IgM with immunodiffusion and complement fixation was negative for infection. Repeat Chest CT demonstrated extensive bronchovascular ground-glass opacities and consolidation consistent with multifocal pneumonia. A positive measles virus vaccine strain detection (MeV-pan measles Ct: 30.4, MeVA-vaccine Ct: 30.6) was reported on hospital day 4. A bronchoalveolar lavage performed on the previous day (day 5) detected both seasonal coronavirus via multiplex syndromic pneumonia panel and measles virus vaccine strain (MeV-pan measles Ct: 33.4, MeVA-vaccine Ct: 33.0). Cytology of the BAL was notable for scattered multinucleated giant cells compatible with viral pneumonia. Other BAL studies were negative, including bacterial, fungal, Nocardia, and AFB cultures; Additional negative infectious studies included Coccidioides serologies, cryptococcal antigen, and urine Legionella antigen.