“…In 1952, Kuhns and Pappenheimer [7] found a significantly higher rate of immediate wheal and flare reactions to D tox oid in allergic compared to nonallergic individuals, while Facktor et al could not confirm these findings for T toxoid [8]. Whether observed adverse reactions to T or D immuni-zations with vaccine combinations with D and T (DT) or D, pertussis (P) and T (DPT) are due to an unspecific irritation by the toxoids itself or by the aluminum component, has been discussed controversially [3,4,9], Elevated serum IgE antibody levels to T are observed af ter booster immunization with aluminum-adsorbed T vac cine [10] and also in relation with DPT vaccine in 1-to 2-year-old children after the first immunization [5]. In crosssectional studies on atopic adults as well as 4 to 17-year-old atopic children T and D IgE antibody levels were found to be higher compared to nonatopic individuals [11,12], Addi tionally, it was found, that older children with markedly ele vated total serum IgE levels synthesized increased anti-D and anti-T IgE antibodies [12].…”