Vaccination-associated anaphylaxis in adults: diagnostic testing ruling out IgE-mediated vaccine allergy.
Re-vaccinations in patients with a history of anaphylaxis after vaccine injection have to be avoided because of the potential risk of recurrent anaphylaxis. However, without diagnostic work-up vaccine allergy remains a presumption and necessary vaccinations may be unjustified withheld. In the last 7 years all patients referred to our allergy clinic with a diagnosis of vaccination-induced anaphylaxis were subjected to allergologic diagnostic procedures to identify IgE-mediated allergy. We evaluated 38 patients with a history of vaccination-associated anaphylaxis. The diagnostic procedure included skin testing and challenge tests, i.e. re-vaccination with the suspected vaccine. In all 38 patients negative skin tests and tolerated challenge tests ruled out IgE-mediated allergic anaphylaxis to vaccine components. Diagnostic testing after suspected vaccination-induced anaphylaxis should be performed to rule out IgE-mediated allergy to the incriminated vaccine and its constituents and to enable future vaccinations with the tested compounds. Therefore, a history of anaphylaxis after vaccination may not be an absolute contraindication for re-vaccination.
Seitz
Cornelia S
CS
Department of Dermatology, University of Würzburg, Würzburg, D-97080 Würzburg, Germany.
Bröcker
Eva-B
EB
Trautmann
Axel
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000707:Anaphylaxis / Q000139:chemically induced* / Q000175:diagnosis*; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000175:diagnosis*; D007073:Immunoglobulin E / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012882:Skin Tests; D014611:Vaccination / Q000009:adverse effects*; D055815:Young Adult
D007073:Immunoglobulin E