Hypersensitivity Reactions to Vaccine Constituents

Abstract

Vaccines are composed of immunogens, preservatives, adjuvants, antibiotics, and manufacturing by-products. Components of vaccines may rarely elicit adverse reactions in susceptible individuals, thus raising concerns regarding vaccine safety. In this report, we add to the medical literature 3 cases of cutaneous delayed-type hypersensitivity to the vaccine preservative aluminum. We provide a review of major constituents in vaccines that have elicited immediate-type or delayed-type hypersensitivity reactions and describe their clinical manifestations. We include a table of the Food and Drug Administration-approved vaccines, which lists the quantities of major components including ovalbumin (egg protein), gelatin, aluminum, neomycin, 2-phenoxyethanol, thimerosal, and formaldehyde. Our goals were to inform physicians on the variety of hypersensitivity reactions to common vaccines and to provide information on the choice of vaccines in patients with suspected hypersensitivity.

Systematic review of potential health risks posed by pharmaceutical, occupational and consumer exposures to metallic and nanoscale aluminum, aluminum oxides, aluminum hydroxide and its soluble salts

“…Contact reactions (delayed-type hypersensitivity with painful erythematous and pruritic eruptions, edema, and blistering) to Al at injection sites do occur (Table 5), but they are rare (Bergfors et al 2005, Ehrlich et al 2008, Leventhal et al 2012, Zhu et al 2009). These reactions can develop weeks, months, or even years after injection of an Al-containing vaccine (Leventhal et al 2012).…”

“…These reactions can develop weeks, months, or even years after injection of an Al-containing vaccine (Leventhal et al 2012). Histological examinations of biopsies from the injection sites revealed granulomatous and foreign body reactions (Garcia-Patos et al 1995) and people with hypersensitivity to Al-containing vaccines generally demonstrate positive patch testing to Al (Bergfors and Trollfors 2012, Beveridge et al 2011, Lehman et al 2008, Netterlid et al 2013).…”

“…Of the vaccines currently registered in the United States (Leventhal et al 2012), 12 contain Al(OH) 3 and 23 contain other Al compounds (Kelso et al 2012). Standard adjuvants in diphtheria, tetanus, and pertussis (DTP) and other vaccines include alum (AlK(SO 4 ) 2 , Al 2 (SO 4 ) 3 , Adju-Phos (Al(PO 4 ) 3 ) Imject Alum (Al(OH) 3 + MgOH) and alhydrogel (Al(OH) 3 ) (Kelso et al 2012, Marrack et al 2009).…”

Management of vaccine safety in Korea

“…The stabilizers, immune potentiators, or antibiotics which are included in the vaccines may cause adverse reaction to susceptible vaccinees. Generally, these hyperreactive responses are postulated to occur because of egg-related antigen (measles, mumps, and rubella [MMR] and influenza vaccine), mercury (hepatitis B vaccine, diphtheria, tetanus, pertussis vaccine [DTaP], Japanese encephalitis vaccine, and influenza vaccine), vaccine stabilizer (MMR), or antibiotics included in the live-attenuated virus vaccine (MMR); however, these mechanisms are not clearly explained, often [1-4]. …”

Practical Patch Testing and Chemical Allergens in Contact Dermatitis

“…Topical medications, anti-fungals, antiseptic sprays such as Merchromine Vaccines -inactivated in fl uenza vaccine is the only vaccine recommended for children below 7 years of age that still contains thimerosal [ 15,290 ] . Adult vaccines still with this at a concentration of 0.01 % or less, in single-and/or multidose forms, include [ 232 ] : Description : a hard, practically colorless material with a faint formaldehyde odor used in nail lacquers and other nail preparations to impart high gloss and fl exibility [ 292,293 ] . Sources :…”