Clin Exp Vaccine Res.  2014 Jan;3(1):50-57. 10.7774/cevr.2014.3.1.50.

Vaccine allergies

Affiliations
  • 1Department of Pediatrics, National Medical Center, Seoul, Korea. ehchung@nmc.or.kr

Abstract

Currently, the increasing numbers of vaccine administrations are associated with increased reports of adverse vaccine reactions. Whilst the general adverse reactions including allergic reactions caused by the vaccine itself or the vaccine components, are rare, they can in some circumstances be serious and even fatal. In accordance with many IgE-mediated reactions and immediate-type allergic reactions, the primary allergens are proteins. The proteins most often implicated in vaccine allergies are egg and gelatin, with perhaps rare reactions to yeast or latex. Numerous studies have demonstrated that the injectable influenza vaccine can be safely administered, although with appropriate precautions, to patients with severe egg allergy, as the current influenza vaccines contain small trace amounts of egg protein. If an allergy is suspected, an accurate examination followed by algorithms is vital for correct diagnosis, treatment and decision regarding re-vaccination in patients with immediate-type reactions to vaccines. Facilities and health care professionals should be available to treat immediate hypersensitivity reactions (anaphylaxis) in all settings where vaccines are administered.

Keyword

Vaccine; Allergy; Influenza; Egg; Anaphylaxis

MeSH Terms

Allergens
Anaphylaxis
Delivery of Health Care
Diagnosis
Egg Hypersensitivity
Gelatin
Humans
Hypersensitivity*
Hypersensitivity, Immediate
Influenza Vaccines
Influenza, Human
Latex
Ovum
Vaccines
Yeasts
Allergens
Gelatin
Influenza Vaccines
Latex
Vaccines

Figure

  • Fig. 1 Recommendations regarding influenza vaccination for persons who report allergy to eggs according to the Advisory Committee on Immunization Practices, United States, 2012-13 influenza season. TIV, trivalent inactivated vaccine. a)Persons with egg allergy may tolerate egg in baked products (for example bread or cake). Tolerance to egg-containing foods does not exclude the possibility of egg allergy. Adapted from Centers for Disease Control and Prevention [40].

  • Fig. 2 The range of ovalbumin content in the different manufacturing companies (A-I) in Korea. Adapted with Roh et al. [41], with permission from The Korean Academy of Pediatric Allergy and Respiratory Disease.


Cited by  3 articles

Vaccine-related Anaphylaxis Cases Confirmed by KCDC from 2001–2016
Eui jeong Roh, Mi-Hee Lee, Kun-Baek Song, Yeon Kyeong Lee, Min-Kyung Kim, Tae Eun Kim, Eun Hee Chung
J Korean Med Sci. 2020;35(38):e337.    doi: 10.3346/jkms.2020.35.e337.

Clinical implication of adverse drug reaction surveillance in children
Eun Hee Chung
Allergy Asthma Respir Dis. 2016;4(5):309-310.    doi: 10.4168/aard.2016.4.5.309.

Analysis of pediatric adverse drug reactions reported to regional pharmacovigilance center of a single university hospital
Do-Woo Kim, Yun-Chang Choi, Young-Seok Lee, Young-Hee Nam, Jin-A Jung
Allergy Asthma Respir Dis. 2018;6(5):263-269.    doi: 10.4168/aard.2018.6.5.263.


Reference

1. Fritsche PJ, Helbling A, Ballmer-Weber BK. Vaccine hypersensitivity: update and overview. Swiss Med Wkly. 2010; 140:238–246.
2. Wood RA, Berger M, Dreskin SC, et al. An algorithm for treatment of patients with hypersensitivity reactions after vaccines. Pediatrics. 2008; 122:e771–e777.
Article
3. Zent O, Arras-Reiter C, Broeker M, Hennig R. Immediate allergic reactions after vaccinations: a post-marketing surveillance review. Eur J Pediatr. 2002; 161:21–25.
Article
4. Bohlke K, Davis RL, Marcy SM, et al. Risk of anaphylaxis after vaccination of children and adolescents. Pediatrics. 2003; 112:815–820.
Article
5. Siegrist CA. Mechanisms underlying adverse reactions to vaccines. J Comp Pathol. 2007; 137:Suppl 1. S46–S50.
Article
6. Jacobs RL, Lowe RS, Lanier BQ. Adverse reactions to tetanus toxoid. JAMA. 1982; 247:40–42.
Article
7. Facktor MA, Bernstein RA, Firemann P. Hypersensitivity to tetanus toxoid. J Allergy Clin Immunol. 1973; 52:1–12.
Article
8. Cox NH, Moss C, Forsyth A. Allergy to non-toxoid constituents of vaccines and implications for patch testing. Contact Dermatitis. 1988; 18:143–146.
Article
9. Vogt T, Landthaler M, Stolz W. Generalized eczema in an 18-month-old boy due to phenoxyethanol in DPT vaccine. Contact Dermatitis. 1998; 38:50–51.
Article
10. Miller E, Waight P, Farrington CP, Andrews N, Stowe J, Taylor B. Idiopathic thrombocytopenic purpura and MMR vaccine. Arch Dis Child. 2001; 84:227–229.
11. Haber P, Sejvar J, Mikaeloff Y, DeStefano F. Vaccines and Guillain-Barré syndrome. Drug Saf. 2009; 32:309–323.
Article
12. Choe YJ, Cho H, Kim SN, Bae GR, Lee JK. Serious adverse events following receipt of trivalent inactivated influenza vaccine in Korea, 2003-2010. Vaccine. 2011; 29:7727–7732.
Article
13. Liang XF, Li L, Liu DW, et al. Safety of influenza A (H1N1) vaccine in postmarketing surveillance in China. N Engl J Med. 2011; 364:638–647.
Article
14. Kelso JM, Jones RT, Yunginger JW. Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gelatin. J Allergy Clin Immunol. 1993; 91:867–872.
Article
15. Sakaguchi M, Nakayama T, Inouye S. Food allergy to gelatin in children with systemic immediate-type reactions, including anaphylaxis, to vaccines. J Allergy Clin Immunol. 1996; 98(6 Pt 1):1058–1061.
Article
16. Bogdanovic J, Halsey NA, Wood RA, Hamilton RG. Bovine and porcine gelatin sensitivity in children sensitized to milk and meat. J Allergy Clin Immunol. 2009; 124:1108–1110.
Article
17. Kelso JM, Greenhawt MJ, Li JT, et al. Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol. 2012; 130:25–43.
Article
18. Nakayama T, Aizawa C. Change in gelatin content of vaccines associated with reduction in reports of allergic reactions. J Allergy Clin Immunol. 2000; 106:591–592.
Article
19. Kuno-Sakai H, Kimura M. Removal of gelatin from live vaccines and DTaP: an ultimate solution for vaccine-related gelatin allergy. Biologicals. 2003; 31:245–249.
Article
20. Centers for Disease Control and Prevention (CDC). Thimerosal in vaccines: a joint statement of the American Academy of Pediatrics and the Public Health Service. MMWR Morb Mortal Wkly Rep. 1999; 48:563–565.
21. Rietschel RL, Bernier R. Neomycin sensitivity and the MMR vaccine. JAMA. 1981; 245:571.
Article
22. Grabenstein J. Clinical management of hypersensitivities to vaccine components. Hosp Pharm. 1997; 32:77–87.
23. DiMiceli L, Pool V, Kelso JM, Shadomy SV, Iskander J. V.A.E.R.S. Team. Vaccination of yeast sensitive individuals: review of safety data in the US vaccine adverse event reporting system (VAERS). Vaccine. 2006; 24:703–707.
Article
24. Kaaber K, Nielsen AO, Veien NK. Vaccination granulomas and aluminium allergy: course and prognostic factors. Contact Dermatitis. 1992; 26:304–306.
Article
25. Bergfors E, Trollfors B, Inerot A. Unexpectedly high incidence of persistent itching nodules and delayed hypersensitivity to aluminium in children after the use of adsorbed vaccines from a single manufacturer. Vaccine. 2003; 22:64–69.
Article
26. Slater JE. Latex allergy. J Allergy Clin Immunol. 1994; 94(2 Pt 1):139–149.
Article
27. Kim KW, Kim SM, Ko EM, et al. Latex anaphylaxis during labor: case report. Korean J Obstet Gynecol. 2002; 45:311–314.
28. Lee W, Lee JH, Park DJ, Kim HH. A case of anaphylactic shock attributed to latex allergy during gastric cancer surgery. J Korean Surg Soc. 2011; 81:Suppl 1. S30–S33.
Article
29. Lear JT, English JS. Anaphylaxis after hepatitis B vaccination. Lancet. 1995; 345:1249.
Article
30. James JM, Burks AW, Roberson PK, Sampson HA. Safe administration of the measles vaccine to children allergic to eggs. N Engl J Med. 1995; 332:1262–1266.
Article
31. Baxter DN. Measles immunization in children with a history of egg allergy. Vaccine. 1996; 14:131–134.
Article
32. Nam SY, Jung EH, Jung JA, et al. Measles, mumps, and rubella immunization in children with egg allergies. J Korean Pediatr Soc. 2001; 44:1031–1035.
33. Pickering LK, Baker CJ, Kimberlin DW, Long SS. Red Book: 2012 report of the Committee on Infectious Diseases. Elk Grove Village: American Academy of Pediatrics;2012.
34. Zeiger RS. Current issues with influenza vaccination in egg allergy. J Allergy Clin Immunol. 2002; 110:834–840.
Article
35. Murphy KR, Strunk RC. Safe administration of influenza vaccine in asthmatic children hypersensitive to egg proteins. J Pediatr. 1985; 106:931–933.
Article
36. James JM, Zeiger RS, Lester MR, et al. Safe administration of influenza vaccine to patients with egg allergy. J Pediatr. 1998; 133:624–628.
Article
37. Des Roches A, Paradis L, Gagnon R. Egg-allergic patients can be safely vaccinated against influenza. J Allergy Clin Immunol. 2012; 130:1213–1216.
Article
38. Greenhawt MJ, Spergel JM, Rank MA, et al. Safe administration of the seasonal trivalent influenza vaccine to children with severe egg allergy. Ann Allergy Asthma Immunol. 2012; 109:426–430.
Article
39. National Center for Immunization and Respiratory Diseases. General recommendations on immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011; 60:1–64.
40. Centers for Disease Control and Prevention (CDC). Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP): United States, 2012-13 influenza season. MMWR Morb Mortal Wkly Rep. 2012; 61:613–618.
41. Roh EJ, Chung EH, Kim JK. Quantitative analysis of egg protein by ELISA in distributed influenza vaccine in Korea. Pediatr Allergy Respir Dis. 2009; 19:345–353.
42. Kelso JM. Raw egg allergy: a potential issue in vaccine allergy. J Allergy Clin Immunol. 2000; 106:990.
Full Text Links
  • CEVR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr