Potential Vaccine Reactions Call for Reasoned Approach

September 4, 2008

Evaluating possible vaccine-related hypersensitivity reactions -- which are a relatively common clinical problem -- is the first step for health care providers to take in minimizing future problems in these patients, according to an article in the September issue of Pediatrics.

THURSDAY, Sept. 4 (HealthDay News) -- Evaluating possible vaccine-related hypersensitivity reactions -- which are a relatively common clinical problem -- is the first step for health care providers to take in minimizing future problems in these patients, according to an article in the September issue of Pediatrics.

Robert A. Wood, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues present an algorithm that guides clinicians through evaluating and treating suspected vaccine hypersensitivity. IgE-mediated reactions -- which usually occur within minutes of exposure -- are far more likely to present life-threatening complications such as airway obstruction than are delayed reactions.

The approach to suspected reactions starts with assessing whether symptoms may be related to the vaccine -- and if so, are possibly IgE-mediated -- based on history, the authors write. Subsequent steps may include skin testing or testing for specific IgE antibodies, withholding subsequent doses, revaccination with alternative vaccines, or revaccination with special precautions, they note.

"Although the treatment of patients with suspected vaccine allergy is clearly an area in need of additional study, we have developed this algorithm and guidelines in the hope that they will provide clinicians with a framework on which patients with suspected reactions can be evaluated and treated. By use of a careful history and appropriate testing, most patients can be safely vaccinated or assured ongoing protection by the assessment of antibody titers," Wood and colleagues conclude.

Several of the study co-authors disclosed financial relationships with pharmaceutical companies.

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