Consensus document on the approach to children with allergic reactions after vaccination or allergy to vaccine components

Immunization is highly effective in preventing infectious diseases and therefore an indispensable public health measure. Allergic patients deserve access to the same publicly recommended immunizations as non‐allergic patients unless risks associated with vaccination outweigh the gains. Whereas the number of reported possible allergic reactions to vaccines is high, confirmed vaccine‐triggered allergic reactions are rare. Anaphylaxis following vaccination is rare, affecting <1/100 000, but can occur in any patient. Some patient groups, notably those with a previous allergic reaction to a vaccine or its components, are at heightened risk of allergic reaction and require special precautions. Allergic reactions, however, may occur in patients without known risk factors and cannot be predicted by currently available tools. Unwarranted fear and uncertainty can result in incomplete vaccination coverage for children and adults with or without allergy. In addition to concerns about an allergic reaction to the vaccine itself, there is fear that routine childhood immunization may promote the development of allergic sensitization and disease. Thus, although there is no evidence that routine childhood immunization increases the risk of allergy development, such risks need to be discussed.

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“…52 Anaphylaxis has been reported in a further HB vaccine recipient with the causative agent most likely being latex. …”

Section: Hepatitis B Vaccinationmentioning

confidence: 99%

Vaccination and allergy: EAACI position paper, practical aspects

Nilsson

Brockow

Alm

et al. 2017

Pediatric Allergy Immunology

127

184

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“…Гиподиа-гностика анафилаксии обусловлена тем, что суще-ствуют многочисленные вариации клинической картины заболевания (например, по степени выра-женности -от незначительной до фатальной; комби-нации симптомов -наличие или отсутствие уртика-рий, симптомов со стороны различных систем и т.д. ; по возрасту больного) [6,7]. Точность представлен-ной для анализа информации зависит от метода фик-…”

Section: распространенность анафилаксииunclassified

“…Ча-сто до вакцинации родители/воспитатели применя-ют блокаторы Н 1 -гистаминорецепторов, что может способствовать стертости клинических проявлений (например, блокирование уртикарий, зуда и т.д.). При подозрении на анафилаксию особое внимание у детей раннего возраста необходимо обращать на та-кие неспецифические симптомы, как резкое появле-ние слабости, вялости, сонливости, гипотонии и ле-таргии [7,23].…”

Section: варианты клинической картины анафилаксииunclassified

“…Наиболее часто за анафилаксию при иммуниза-ции принимают вегетативные реакции, связанные со страхом перед инъекцией (потеря сознания, паническая атака, гипервентиляция, рвота, судо-роги). Кроме того, анафилаксию следует диффе-ренцировать с аспирацией при гастроэзофагеаль-ном рефлюксе, другими причинами шока (сепсис), эпилептическим припадком, наследственным ан-гионевротическим отеком [7].…”

Section: дифференциальная диагностика анафилаксииunclassified

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Anaphylaxis and Vaccination: Risks and Realities

Петровна¹,

Николаевич²

2018

Ross. vestn. perinatol. pediatr.

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The article is about the problem of anaphylaxis in the post-vaccination period. Data on the frequency of its prevalence and lethality depending on the type of vaccine are presented. Variants of a clinical picture of anaphylaxis and differential-diagnostic approaches are indicated. The major causal components of vaccines, anaphylaxis inducers, and methods for their identification are mentioned. Therapeutic approaches are analyzed, false myths and contraindications to vaccination are indicated. The experience of carrying out preventive individual measures is generalized.

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“…It should be highlighted that the incidence of severe allergic reactions is very low, ranging between 0.5 and one cases/100,000 doses [14]. Currently, in Australia and US, anaphylaxis and encephalopathy are the only conditions determining absolute contraindication to revaccination with the suspect vaccine [15,16].…”

Section: Kinds Of Vaesmentioning

confidence: 99%

Adverse Events Related to Vaccination (VAEs): How to Manage the Further Doses of Immunization and Parents’ Hesitancy

Gattinara¹,

Bellelli²,

Angelone³

et al. 2017

Vaccines

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This study supports the evidence that after vaccine-related reactions, it is still possible to carry out the immunization protocol.Out of more than 1000 patients per year evaluated for potential vaccine-related risks (patients with chronic/serious diseases and events connected with vaccination), 76 (6%) presented previous vaccine adverse events (VAEs). The decision about whether to continue child vaccination is made evaluating diferent factors: absence of speciic contraindications, parents' counseling, adequate hospital seting, choice of an appropriate and individualized schedule. None of the 76 children vaccinated after VAEs presented further side efects.Our data demonstrate that VAE is not a recurring event. The real risk of a new VAE is mostly associated with the serious allergic reactions (IgE-mediated anaphylaxis) and parents should be aware of this information, so that the widespread fear of VAE recurrence can be contained. Indeed, this type of concerns represents one of the main reasons for vaccination hesitancy, which leads to incomplete vaccination schedules.Conclusions: This chapter encourages clinicians to take advantage of the available VAE assessment algorithms to objectively evaluate real vaccine risk of VAE and provide parents with correct information, considering that VAEs are rare and severe reactions are extremely rare.

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Consensus document on the approach to children with allergic reactions after vaccination or allergy to vaccine components

Cited by 27 publications

References 64 publications

Vaccination and allergy: EAACI position paper, practical aspects

Vaccination and allergy: EAACI position paper, practical aspects

Anaphylaxis and Vaccination: Risks and Realities

Adverse Events Related to Vaccination (VAEs): How to Manage the Further Doses of Immunization and Parents’ Hesitancy

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