Side Effects for Bexsero
The most commonly reported (≥10%) solicited adverse reactions in a Phase 3 clinical trial (Study 1) were pain at the injection site (87%-92%), fatigue (45%-49%), headache (37%-41%), nausea (11%-13%), erythema (10%-15%), myalgia (10%-14%), and swelling (10%-14%).
Clinical Trials Experience
The safety of BEXSERO was evaluated in 5 clinical studies (Table 1) in which a total of 4,861 participants aged 10 through 25 years received at least 1 dose of BEXSERO. Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a vaccine cannot be directly compared with rates in the clinical trials of another vaccine and may not reflect the rates observed in practice.
Table 1. BEXSERO Clinical Studies
| Study (NCT#) |
Participant Age Range |
Countries |
BEXSERO Recipientsa |
Study 1
(NCT04502693) |
10-25 years |
United States (U.S.), Australia, Canada, Czech Republic, Estonia, Finland, and Turkey |
1,803 |
Study 2
(NCT01423084) |
11-17 years |
Canada and Australia |
342 |
Study 3
(NCT01214850) |
18-24 years |
United Kingdom (U.K.) |
974 |
Study 4
(NCT00661713) |
11-17 years |
Chile |
1,622 |
Study 5
(NCT01272180) |
10-25 years |
U.S. and Poland |
120 |
| a Recipients who received at least 1 dose of BEXSERO |
In Study 1, conducted in the United States (U.S.), Australia, Canada, Czech Republic, Estonia, Finland, and Turkey, 1,803 participants aged 10 through 25 years received at least 1 dose of BEXSERO either as a 0-, 2-, 6-month schedule (n = 897) or 0-, 6-month schedule (n = 906). A single dose of MENVEO [Meningococcal (Groups A, C, Y, and W-135) Oligosaccharide Diphtheria CRM197 Conjugate Vaccine] was administered 1 month after the third dose in the 0-, 2-, 6-month group and 2 months after the first dose of BEXSERO in the 0-, 6-month group (these participants received saline placebo at month 7). A separate group (n = 178) received a single dose of MENVEO followed 6 months later by 2 doses of BEXSERO administered 1 month apart (these participants received saline placebo at month 2). Approximately 30% of participants were from the U.S. In this trial, the median age was 16 years, males comprised 47%, and 89% of participants were White, 5% were Asian, 4% were Black, and 2% were of other racial groups. Among study participants, 5% were Hispanic.
In Study 2, an uncontrolled study conducted in Canada and Australia, 342 participants aged 11 through 17 years received at least 1 dose of BEXSERO, including 338 participants who received 2 doses of BEXSERO 1 month apart (unapproved dosing schedule). The median age was 13 years, males comprised 55%, and 80% of participants were White, 10% were Asian, 4% were Native American/Alaskan, and 4% were of other racial groups.
In Study 3, conducted in the United Kingdom (U.K.), 974 university students aged 18 through 24 years received at least 1 dose of BEXSERO, including 932 participants who received 2 doses of BEXSERO 1 month apart (unapproved dosing schedule). Comparator groups received 1 dose of MENVEO followed by 1 dose of placebo containing aluminum hydroxide (n = 956) or 2 doses of IXIARO (Japanese Encephalitis Vaccine, Inactivated, Adsorbed) (n = 947). Across groups, median age was 20 years, males comprised 46%, and 88% of participants were White, 5% were Asian, 2% were Black, <1% were Hispanic, and 4% were of other racial groups.
In Study 4, conducted in Chile, 1,622 participants aged 11 through 17 years received at least 1 dose of BEXSERO according to approved and unapproved dosing schedules. A control group of 128 participants received at least 1 dose of placebo containing aluminum hydroxide. In this study, median age was 14 years, males comprised 44%, and 99% were Hispanic.
In Study 5, conducted in the U.S. and Poland, 120 participants aged 10 through 25 years received at least 1 dose of BEXSERO, including 112 participants who received 2 doses of BEXSERO 2 months apart (unapproved dosing schedule); 97 participants received saline placebo followed by MENVEO. Across groups, the median age was 13 years, males comprised 49%, and 60% of participants were White, 34% were Hispanic, 4% were Black, <1% were Asian, and 2% were of other racial groups.
Local and systemic reactogenicity data were solicited from all participants in the trials with the exception of one trial (Study 3) where they were solicited in a subset of participants only. Reports of unsolicited adverse events occurring within the first 7 days after each vaccination were collected in all trials. Reports of unsolicited adverse events occurring within the 30 days after each vaccination were collected in 2 trials (Study 1, Study 5).
Reports of all serious adverse events, medically attended adverse events, and adverse events leading to premature withdrawal were collected throughout the study period of 2 months (Study 2), 8 months (Study 5), or 12 months (Study 1, Study 3, Study 4).
Solicited Adverse Reactions
The rates of local and systemic adverse reactions reported in Study 1 among participants aged 10 through 25 years following each dose of BEXSERO or a single dose of MENVEO are presented in Table 2.
Table 2. Percentage of Participants Aged 10 through 25 Years Reporting Solicited Local and Systemic Adverse Reactions within 7 Days of BEXSERO or MENVEO, by Dose (Solicited Safety Set, Study 1)
| Solicited Reactiona |
BEXSERO
(0, 6 Months)
% |
BEXSERO
(0, 2, 6 Months)
% |
MENVEO
(Single Dose)
% |
| Dose 1 |
Dose 2 |
Dose 1 |
Dose 2 |
Dose 3 |
Dose 1 |
| n = 894 |
n = 759 |
n = 885 |
n = 823 |
n = 765 |
n = 178 |
| Local Adverse Reactions |
| Pain |
Any |
92 |
89 |
91 |
87 |
89 |
38 |
| Severe |
6 |
8 |
6 |
7 |
11 |
0 |
| Erythema |
Any |
10 |
12 |
10 |
11 |
15 |
6 |
| Severe |
1 |
1 |
1 |
1 |
2 |
1 |
| Swelling |
Any |
10 |
11 |
10 |
12 |
14 |
6 |
| Severe |
1 |
2 |
1 |
1 |
1 |
1 |
| Induration |
Any |
7 |
8 |
7 |
8 |
7 |
4 |
| Severe |
2 |
1 |
1 |
1 |
1 |
0 |
| Systemic Adverse Reactions |
| Fatigue |
Any |
46 |
45 |
48 |
45 |
49 |
44 |
| Severe |
1 |
3 |
2 |
2 |
3 |
2 |
| Nausea |
Any |
12 |
11 |
13 |
13 |
12 |
15 |
| Severe |
1 |
0.4 |
1 |
1 |
0.3 |
1 |
| Myalgia |
Any |
12 |
14 |
10 |
14 |
14 |
7 |
| Severe |
1 |
0.4 |
0.2 |
1 |
1 |
0 |
| Arthralgia |
Any |
8 |
7 |
6 |
9 |
9 |
10 |
| Severe |
0.3 |
0 |
0.2 |
1 |
0.4 |
0 |
| Headache |
Any |
37 |
37 |
41 |
37 |
40 |
39 |
| Severe |
1 |
1 |
1 |
2 |
2 |
2 |
| Fever |
Any |
2 |
3 |
2 |
3 |
3 |
2 |
|
Severe |
0.1 |
0 |
0.1 |
0 |
0.1 |
0 |
Study 1: NCT04502693.
a Erythema, swelling, and induration: Any (≥25 mm); Severe (>100 mm). Pain, fatigue, nausea, myalgia, arthralgia, headache: Any includes Mild (transient with no limitation in normal daily activity), Moderate (some limitation in normal daily activity), and Severe (unable to perform normal, daily activity). Fever: Any (≥38.0°C/100.4°F); Severe (≥40.0°C/104.0°F). |
Solicited adverse reactions were also collected in 4 additional clinical trials (Studies 2-5) in participants aged 10 through 25 years who received BEXSERO. Pain was the most common local adverse reaction reported (83% to 96%), with severe pain reported by 8% to 29% of participants, across trials. Among the systemic reactions collected, myalgia (37% to 75%), headache (21% to 47%), and fatigue/malaise (17% to 58%) were the most commonly reported systemic reactions across trials.
Unsolicited Adverse Events
In Study 1, unsolicited adverse events (non-serious and serious) that occurred within 7 days of any dose of study vaccination were reported by 14% of participants in the group receiving BEXSERO as a 0-, 6-month schedule (n = 900), 13% of participants in the group receiving BEXSERO as a 0-, 2-, 6-month schedule (n = 893), and 20% of participants in the MENVEO group (n = 178).
A non-serious event of arthritis with onset 10 days after receipt of BEXSERO in a 24-year-old male was assessed as vaccine-related by the study investigator. The participant, later found to be HLA-B27 positive, may be at increased risk for arthritis unrelated to vaccination.
In the other controlled trials (Study 3, Study 4, Study 5) (BEXSERO n = 2,221, control n = 2,204), non-serious unsolicited adverse events that occurred within 7 days of any dose were reported by 439 (20%) participants receiving BEXSERO and 197 (9%) control recipients. Unsolicited adverse reactions that were reported among at least 2% of participants and were more frequently reported in participants receiving BEXSERO than in control recipients were injection site pain, headache, injection site induration unresolved within 7 days, and nasopharyngitis.
Serious Adverse Events
In Study 1, serious adverse events that occurred within 30 days of any dose of study vaccination were reported by 1.2% of participants in the group receiving BEXSERO as a 0-, 6-month schedule (n = 900), 1.0% of participants in the group receiving BEXSERO as a 0-, 2-, 6-month schedule (n = 893), and 0% of participants in the MENVEO group (n = 178). None of these events were considered related to BEXSERO.
Overall, in Studies 2-5, among 3,058 participants aged 10 through 25 years who received at least 1 dose of BEXSERO, 66 (2.1%) participants reported serious adverse events at any time during the trial. In the 3 controlled trials (Study 3, Study 4, Study 5) (BEXSERO n = 2,716, control n = 2,078), serious adverse events within 30 days after any dose were reported in 23 (0.8%) participants receiving BEXSERO and 10 (0.5%) control recipients. In Study 4, among participants who received 3 doses of BEXSERO (n = 628), 15 (2.4%) participants reported serious adverse events at any time during the trial.
Additional Pre-Licensure Safety Experience
In response to outbreaks of serogroup B meningococcal disease at 2 universities in the U.S., BEXSERO was administered as a 2-dose series at least 1 month apart. Information on serious adverse events was collected for a period of 30 days after each dose from 15,351 individuals aged 16 through 65 years who received at least 1 dose. Overall, 50 individuals (0.3%) reported serious adverse events, including one reaction considered related to vaccination, a case of anaphylaxis within 30 minutes following vaccination.
Postmarketing Experience
The following adverse reactions have been identified during post-approval use of BEXSERO. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to the vaccine.
Blood And Lymphatic System Disorders
Lymphadenopathy.
General Disorders And Administration Site Conditions
Injection site reactions (including extensive swelling of the vaccinated limb, blisters at or around the injection site, and injection site nodule which may persist for more than 1 month).
Immune System Disorders
Allergic reactions (including anaphylactic reactions), rash, eye swelling.
Nervous System Disorders
Syncope, vasovagal responses to injection.
Drug Interactions for Bexsero
No Information Provided