title: A decade of vaccinating allergic travellers: a clinical audit.
abstract: Adverse reactions following vaccination are rare but may include potentially fatal anaphylaxis. This audit is a retrospective review of 38 patients with a history, or potential risk, of 'vaccine allergy' referred to an Infectious Diseases Unit for vaccination over a 10 year period. A total of 59 patient encounters were recorded, of which 89.8% were uneventful. Of the 6 adverse events, 3 patients had a local reaction, 1 patient developed urticaria and 1 patient had a vasovagal episode. Only 1 patient developed anaphylaxis secondary to vaccination, and she had no prior history of vaccine allergy. Of these patients 17 had a history suggesting the need for immunological investigation but only 7 had laboratory evidence of allergy. The differential diagnosis of anaphylaxis includes vasovagal reactions and non-specific mediator release and immunological work-up of such events can help avoid such patients being incorrectly labelled as allergic. The vast majority of immunisations are uncomplicated and patients with a history of allergic reactions to vaccination may be vaccinated safely in a controlled setting. Unduly conservative guidelines risk withholding vaccines providing protection against dangerous pathogens but which can be safely administered.
authors: Regional Infectious Diseases Unit, Western General Hospital, Crewe Road, Edinburgh EH4 2XU, United Kingdom. mike.e.jones@luht.scot.nhs.uk
authors: Andrew D
authors: AD
authors: McCallum
authors: Christopher J A
authors: CJ
authors: Duncan
authors: Rona
authors: R
authors: MacDonald
authors: Michael E
authors: ME
authors: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology*; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D007114:Immunization / Q000706:statistics & numerical data*; D007159:Immunologic Tests; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014195:Travel; D014612:Vaccines / Q000008:administration & dosage* / Q000009:adverse effects*
chemical_list: D014612:Vaccines