title: A review of a paediatric emergency department vaccination programme for patients at risk of allergy/anaphylaxis.
abstract: OBJECTIVE
  We sought to review the clinical outcomes of patients referred to our emergency department (ED) vaccination service for children with a history of allergy or anaphylaxis or in whom there was a concern of a significant adverse reaction.
  
  
  METHODS
  This was a prospective observational cohort study set in an urban tertiary Paediatric ED. All attendances for any childhood vaccination for a 5-year period (from January 1, 2006 to December 31, 2010) were included. Our primary outcome measure was any adverse reaction as a result of the vaccine administered.
  
  
  RESULTS
  A total of 446 vaccines were administered during the study period in 374 patients. Of these vaccinations, 310 (69.5%) were Measles, Mumps, Rubella (MMR). The majority of patients (348, 93%) were referred from the community. Suspected egg allergy was the reason for the majority of referrals for MMR (261/310 (84.2%)). Only six patients (1.3%) experienced an immediate reaction to a vaccination. All reactions were minor.
  
  
  CONCLUSIONS
  This is one of the largest studies looking at childhood vaccinations performed in a hospital setting for children who are 'at risk' of allergy, anaphylaxis or hypersensitivity. A significant number of referrals were unwarranted and the majority could have been safely managed in the community.
authors.affiliation: Paediatric Emergency Research Unit, Department of Emergency Medicine, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Cronin
authors.forename: Annemarie
authors.initials: A
authors.lastname: Scorr
authors.forename: Sinead
authors.initials: S
authors.lastname: Russell
authors.forename: Siobhan
authors.initials: S
authors.lastname: McCoy
authors.forename: Sean
authors.initials: S
authors.lastname: Walsh
authors.forename: Ronan
authors.initials: R
authors.lastname: O'Sullivan
mesh_terms: D000707:Anaphylaxis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D006967:Hypersensitivity / Q000453:epidemiology; D007223:Infant; D008297:Male; D022542:Measles-Mumps-Rubella Vaccine; D011446:Prospective Studies; D012017:Referral and Consultation; D018570:Risk Assessment; D014611:Vaccination / Q000009:adverse effects
chemical_list: D022542:Measles-Mumps-Rubella Vaccine