Anaphylaxis to measles, mumps, and rubella vaccine mediated by IgE to gelatin.
BACKGROUND
Allergic reactions to measles, mumps, and rubella (MMR) vaccine are rare; some have been attributed to allergy to trace quantities of egg proteins. We report a 17-year-old female who had an anaphylactic reaction to MMR vaccine. A primary vaccination with MMR at age 15 months had been uneventful. She is not allergic to eggs; however, ear and throat pruritus and tongue swelling develop after she eats gelatin. MMR vaccine contains gelatin as a stabilizer.


RESULTS
Prick skin tests were positive to 1:10 wt/vol dilutions of MMR vaccine and gelatin but negative to egg. By immunoassay, her serum IgE antibodies were elevated to both MMR vaccine and gelatin, but not to isolated MMR antigens. IgE binding to the gelatin carrier could be inhibited in a dose-dependent fashion by addition of not only MMR vaccine but also gelatin from a variety of animal sources. Immunoblotting confirmed the presence of IgE antibodies to multiple gelatin components as well as to MMR vaccine components.


CONCLUSIONS
We conclude that the patient has an anaphylactic sensitivity to gelatin, and that her anaphylaxis to MMR vaccine was caused by the gelatin component. This sensitivity may explain other cases of MMR anaphylaxis.
Kelso
J M
JM
Department of Internal Medicine (Allergy Division), Naval Hospital, San Diego, CA 92134-5000.
Jones
R T
RT
Yunginger
J W
JW
D000293:Adolescent; D000707:Anaphylaxis / Q000209:etiology*; D004338:Drug Combinations; D004527:Egg Proteins / Q000276:immunology; D005260:Female; D005780:Gelatin / Q000276:immunology*; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood / Q000276:immunology*; D008458:Measles Vaccine / Q000009:adverse effects* / Q000276:immunology; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine / Q000009:adverse effects* / Q000276:immunology; D012411:Rubella Vaccine / Q000009:adverse effects* / Q000276:immunology; D012882:Skin Tests
D004338:Drug Combinations; D004527:Egg Proteins; D008458:Measles Vaccine; D022542:Measles-Mumps-Rubella Vaccine; D009108:Mumps Vaccine; D012411:Rubella Vaccine; D007073:Immunoglobulin E; D005780:Gelatin