Fabrizio Franceschini1, Paolo Bottau2, Silvia Caimmi3, Fabio Cardinale4, Giuseppe Crisafulli5, Lucia Liotti6, Guido Pellegrini7, Diego Peroni8, Francesca Saretta9, Carla Mastrorilli10, Carlo Caffarelli10. 1. From the UOC Pediatria, Azienda Ospedaliero-Universitaria "Ospedali Riuniti," Ancona, Italy. 2. UOC Pediatria, Ospedale di Imola, Italy. 3. Clinica Pediatrica-Fondazione IRCCS-Policlinico San Matteo, Pavia, Italy. 4. UOC di Pediatria, Azienda Ospedaliera-Universitaria "Consorziale-Policlinico," Ospedale Pediatrico Giovanni XXIII, Bari, Italy. 5. UO Allergologia, Dipartimento di Pediatria, Università di Messina, Messina, Italy. 6. UOC di Pediatria, Ospedale di Senigallia, Italy. 7. UOC di Pediatria, Ospedale Città di Sesto San Giovanni, ASST Nord Milano, Sesto San Giovanni, Italy. 8. Clinica Pediatrica, Università di Pisa, Pisa, Italy. 9. UOC di Pediatria, Ospedale di Palmanova, AAS2 Bassa Friulana-Isontina, Palmanova, Italy. 10. Clinica Pediatrica, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy.
Abstract
BACKGROUND: Vaccines often contain potentially allergenic material in addition to pathogen-specific immunogens that may induce allergic reactions. Parents and physicians often suspect that adverse reactions to vaccines are allergic in etiology. The concern that some of the substances contained in vaccines may trigger an anaphylactic reaction may lead to a low vaccination adherence with emergence of infectious disease epidemics. OBJECTIVE: To provide practical suggestions for managing children suspected to have an allergic reaction to a vaccine. METHODS: Information was obtained from a search of guidelines and relevant studies on allergic reactions to vaccines for infectious diseases. RESULTS: True allergic reactions elicited by a vaccine are rare. Skin testing to the vaccine and to its components may identify the triggering agent. Graded dosing desensitization is helpful in children sensitized to the offending vaccine. CONCLUSION: All children with a suspected allergic reaction to a vaccine should be carefully evaluated by routine allergy tests. When it is necessary, further immunization should be given under strict medical surveillance, which ensures that every child can safely complete the vaccination schedule.
BACKGROUND: Vaccines often contain potentially allergenic material in addition to pathogen-specific immunogens that may induce allergic reactions. Parents and physicians often suspect that adverse reactions to vaccines are allergic in etiology. The concern that some of the substances contained in vaccines may trigger an anaphylactic reaction may lead to a low vaccination adherence with emergence of infectious disease epidemics. OBJECTIVE: To provide practical suggestions for managing children suspected to have an allergic reaction to a vaccine. METHODS: Information was obtained from a search of guidelines and relevant studies on allergic reactions to vaccines for infectious diseases. RESULTS: True allergic reactions elicited by a vaccine are rare. Skin testing to the vaccine and to its components may identify the triggering agent. Graded dosing desensitization is helpful in children sensitized to the offending vaccine. CONCLUSION: All children with a suspected allergic reaction to a vaccine should be carefully evaluated by routine allergy tests. When it is necessary, further immunization should be given under strict medical surveillance, which ensures that every child can safely complete the vaccination schedule.