Allergy to non‐toxoid constituents of vaccines and implications for patch testing

Cox, Neil; Moss, Celia; Forsyth, A.

doi:10.1111/j.1600-0536.1988.tb04500.x

Cited by 65 publications

(26 citation statements)

References 14 publications

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“…The local symptoms and signs are similar to those observed in 645 children in the trials of vaccines produced by Statens Seruminstitut [2] and in earlier published case descriptions [1,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18]. The parents' reports on the symptoms and sufferings of their children were confirmed in the medical records.…”

Section: Discussionsupporting

confidence: 73%

“…The parents' reports on the symptoms and sufferings of their children were confirmed in the medical records. Local hyperpigmentation and hypertrichosis, considered to be post-inflammatory reactions, have also been described by other authors [7,8,15,16,18]. The aggravated itching and swelling of the nodules, which was also seen in 39% of the children with pruritic nodules in the vaccine trials [2], is an interesting but unexplained observation, similar to the impaired symptoms that have been observed by other authors premenstrually subjects [18] and during patch testing [7].…”

Section: Discussionsupporting

confidence: 50%

“…Local hyperpigmentation and hypertrichosis, considered to be post-inflammatory reactions, have also been described by other authors [7,8,15,16,18]. The aggravated itching and swelling of the nodules, which was also seen in 39% of the children with pruritic nodules in the vaccine trials [2], is an interesting but unexplained observation, similar to the impaired symptoms that have been observed by other authors premenstrually subjects [18] and during patch testing [7]. Although the local symptoms seem to subside with time, the long-term prognosis cannot be determined until the children have been followed for many years.…”

Section: Discussionmentioning

confidence: 83%

“…The pruritic nodules, which lasted for many years and caused considerable discomfort, were, in 77% of the cases, associated with hypersensitivity to Al, as demonstrated by an epicutaneous test. Previously, not more than about 100 cases of persistent pruritic nodules at the injection site of Al-adsorbed vaccines had been reported in the literature since 1960, most commonly after diphtheria-tetanus (DT), pertussis and hepatitis B vaccines [1,3,4,5,6,7,8,9,10,11,12,13,14,15,16,18,19].…”

Section: Introductionmentioning

confidence: 99%

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Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines

2005

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Rare cases of persistent pruritic nodules, sometimes associated with aluminium (Al) allergy, have been reported after the use of several Al adsorbed vaccines. During vaccine trials in the 1990s a high incidence of pruritic nodules (645 cases/76,000 recipients), in 77% associated with Al allergy, was observed after the administration of diphtheria-tetanus / acellular pertussis (DT/aP) vaccines from a single producer. In the present report 19 children with pruritic nodules after vaccination with Al hydroxide-adsorbed DTaP/polio+Hib (Infanrix, Pentavac) are described. The children had intensely itching nodules at the injection site, often aggravated during upper respiratory tract infections, and local skin alterations. So far, the symptoms have persisted for up to 7 years. The median time between vaccination and onset of symptoms was 1 month. 16 children were epicutaneously tested for Al, all with positive reactions indicating delayed hypersensitivity to Al. The condition is not commonly known but is important to recognise, as the child and the family may suffer considerably. Future vaccinations with Al-adsorbed vaccines may cause aggravation of the symptoms and the Al allergy. Al-containing skin products, such as antiperspirants, may cause contact dermatitis. Nodules may be mistaken for tumours. Even though the incidence of itching nodules and Al allergy after administration of Infanrix, Pentavac and other Al-adsorbed vaccines is probably low, research to replace Al adjuvants seems appropriate. We conclude that intensely itching subcutaneous nodules, lasting for many years, and hypersensitivity to aluminium may occur after DTaP/polio+Hib vaccination of infants.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

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Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines

2005

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“…Die Reaktionen sensibilisierter Personen auf Impfstoffe, die ein aluminiumhaltiges Adjuvans enthalten, bestehen meistens in schmerzhaften und juckenden Knötchen an der Injektionsstelle. In wenigen Fällen ist auch eine lokale (auf den Injektionsbereich beschränkte) oder generalisierte (auf den ganzen Körper ausgebreitete) Dermatitis (Hautentzündung) beschrieben worden [34].…”

Section: Aluminiumunclassified

Vaccine safety

Weisser

Barth

Keller‐Stanislawski

2009

Bundesgesundheitsbl.

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Vaccinations rank among the most effective preventive measures for protection against infectious diseases. Advances in development, production, and control of vaccines facilitate the increasing standards of vaccine safety and tolerance. Comprehensive pre-clinical and clinical tests as well as modern manufacturing and testing methods ensure that vaccines marketed nowadays are safe. As a rule, clinical trials performed before granting the marketing authorisation identify the most frequent adverse events and these results are used to evaluate the safety of the product. Such trials can identify relatively rare adverse events, which occur with a frequency of 1:1,000 to 1:10,000 of all vaccinated individuals. These adverse events will then be included in the summary of product characteristics (SPC) for the vaccine. Even after comprehensive clinical trials of vaccines, it is possible that very rare adverse events may be observed for the first time during general use of a vaccine. In recent years concern over real and alleged risks of vaccines relative to their benefit has grown in many countries including Germany. One reason for this is the fact that most infections that were previously feared have now faded from memory. This situation can be ascribed in part to the success of vaccination. In recent years an increased awareness of substantiated and assumed risks following immunization has been reported in Germany as well as many other countries. In part this may be due to the absence of infectious disease-related mortality and morbidity and to the fact that the severity of vaccine-preventable diseases is no longer observable. Consequently, rare and hypothetical adverse events attain undue public attention. As vaccination willingness diminishes, a resulting lower vaccination rate renders the population susceptible to the natural wild type infection with concomitant increases in mortality and morbidity of vaccine-preventable diseases. Thus, very rare or even unproven adverse events have attracted public attention. Declining vaccination rates resulting from these fears may result in a renewed increase of vaccine-preventable diseases. Adverse events following immunization (AEFI) need to be recognized and adequately assessed. This review presents the scientific knowledge concerning causality and frequency of several AEFI and hypothetical risks.

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Aluminium‐, Aluminiumoxid‐, und Aluminiumhydroxid‐haltige Stäube [MAK Value Documentation in German language, 2007]

2012

The MAK‐Collection for Occupational Health and Safety

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Veröffentlicht in der Reihe Gesundheitsschädliche Arbeitsstoffe , 43. Lieferung, Ausgabe 2007 Der Artikel enthält folgende Kapitel: Exposition Allgemeiner Wirkungscharakter Wirkungsmechanismus Toxikokinetik und Metabolismus Aufnahme, Verteilung, Ausscheidung Metabolismus Erfahrungen beim Menschen Einmalige Exposition Wiederholte Exposition Wirkung auf Haut und Schleimhäute Allergene Wirkung Reproduktionstoxizität Genotoxizität Kanzerogenität Tierexperimentelle Befunde und In‐vitro‐Untersuchungen Akute Toxizität Subakute, subchronische und chronische Toxizität Wirkung auf Haut und Schleimhäute Allergene Wirkung Reproduktionstoxizität Genotoxizität Kanzerogenität Sonstige Wirkungen Bewertung

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Allergy to non‐toxoid constituents of vaccines and implications for patch testing

Cited by 65 publications

References 14 publications

Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines

Nineteen cases of persistent pruritic nodules and contact allergy to aluminium after injection of commonly used aluminium-adsorbed vaccines

Vaccine safety

Aluminium‐, Aluminiumoxid‐, und Aluminiumhydroxid‐haltige Stäube [MAK Value Documentation in German language, 2007]

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