Allergens in vaccinations

Egg (via chick embryonic fluid), Gelatin, Soy, Yeast and Antibiotics= Allergens in Vaccinations... note that antibiotics may also serve as allergens with a risk of anaphylaxis but this is addressed in the antibiotics page.

http://www.wellness.com/reference/allergies/vaccine-allergy/symptoms-and-causes

Patients may develop an allergic reaction to a vaccine if the immune system overreacts to substances contained in the vaccine. Most allergic reactions occur when the vaccine contains antibiotics, egg proteins, gelatin, or mercury.

Typically, an allergic response is not triggered the first time the body encounters the allergen (substance that causes an allergic reaction). In fact, some people can be exposed to the allergen several times before an allergy develops. It is only after one or more episodes of exposure to an allergen that the immune system becomes sensitized. During this process, the body's white blood cells develop immunoglobulin E (IgE) antibodies to the allergens. Once sensitized, the antibodies quickly detect and bind to the allergens in the body.

After binding to allergens, antibodies trigger other immune cells to release chemicals (such as histamine) that cause allergic symptoms, such as runny nose, watery eyes, and sneezing, as well as anaphylaxis. Anaphylaxis is a severe allergic reaction that affects many parts of the body. Symptoms vary from mild to severe and may include breathing difficulties, shock, and loss of consciousness. Anaphylaxis is a potentially fatal reaction that requires immediate treatment.

SYMPTOMS

Anaphylaxis (anaphylactic shock): Anaphylaxis is a systemic allergic reaction, which means that many parts of the body are affected. Symptoms of anaphylaxis can vary from mild to severe and may include low blood pressure, breathing difficulties, chest pain, hives, and loss of consciousness. The time lapse between contact with the allergen and anaphylactic symptoms varies among individuals. Symptoms may appear immediately or may be delayed from 30 minutes to one hour after exposure. Symptoms may also disappear and then recur hours later. Once symptoms arise, they progress quickly. Anyone with symptoms of anaphylaxis should seek immediate treatment.

Angioedema: Some hypersensitive patients may experience angioedema in response to a vaccine. Angioedema refers to the swelling that occurs in the tissue just below the skin. Angioedema is similar to hives, except it occurs deeper in the skin. The swellings, known as welts, usually appear around the eyes and mouth. They may also be present on the hands, feet, and throat.

Asthma: Asthma symptoms, including coughing, wheezing, shortness of breath, or difficulty breathing, may be triggered by vaccine allergies, especially in infants and young children.

Hives: Some patients may develop hives. Hives are red, itchy swollen welts on the skin that may appear suddenly and disappear quickly. They often develop in clusters, with new clusters appearing as other areas clear up.

http://www.vran.org/vaccines/anaphylaxis/vaccine-ana.htm

Allergy 1978 Jun:33(3):155-9 Aluminum phosphate but not calcium phosphate stimulates the specific IgE response in guinea pigs to tetanus toxoid. It is hypothesized that the regular application of aluminum compound-containing vaccines on the entire population could be one of the factors leading to the observed increase of allergic diseases. PMID 707792

Pediatric Allergy Immunol 1994 May;5(2):118-23 Immunoglobulin E and G responses to pertussis toxin after booster immunization in relation to atopy, local reactions and aluminum content of the vaccines. The role of aluminum for IgG and IgE responses to pertussis toxin (PT), as well as for side effects, was investigated in 49 children with known atopy status………………the addition of aluminum to the pertussis vaccine was, thus, associated with a stronger IgG antibody response, but tended also to induce a stronger IgE antibody response. The correlation between total IgE and PT-IgE, which was most prominent in children with atopy, indicates that the role of immunization for the development of allergy merits further studies. PMID 808719

http://lrsitbrd.nic.in/IJTB/Year%201990/October%201990/october%201990%20D.pdf

A PILOT STUDY TO ASSESS POST VACCINATION ALLERGY INDUCED
AFTER BCG VACCINATION IN INFANTS VACCINATED BY AUXILIARY
NURSE-MIDWIVES IN AJMER (RAJASTHAN)

Yet, the observed mean size of post-vaccination allergy in both the groups was below 6 mm i.e. much lower than what could be expected. Since the maximum extent of post-vaccination allergy occurs three to four months following vaccination, the possible waning of allergy, if any, that could have occurred in the two to three months that elapsed after the target timing could not have been so profound.

http://www.chiroweb.com/mpacms/dc/article.php?id=31598

Do DTP and Tetanus Vaccinations Cause Asthma?
New Study Shows Vaccinated Children Twice as Likely to Get Asthma and Other Allergy-Related Symptoms
By Michael Devitt

A new study in the Journal of Manipulative and Physiological Therapeutics1 supports the findings of three previous studies that children who receive diphteria-tetanus-pertussis (DTP) or tetanus vaccines are more likely to have a “history of asthma” or other “allergy-related respiratory symptoms.” The study reviewed data from the Third National Health and Nutrition Examination Survey, which was conducted by the National Center for Health Statistics from 1988 to 1994.

http://www.vaccination.inoz.com/asthma3.html

Michel Odent found the frequency of asthma in a group of fully vaccinated children to be 11%, while a 1997 NZ study(21) found 23%. Both found the frequency in the unvaccinated children to be only 0 1%. Several studies have found the rate higher after vaccines that use aluminum hydroxide as adjuvants in the postnatal period.(22)

Significantly, there was a decrease in deaths from asthma in the U.S. for some years until the DPT vaccine was mandated in the U.S. for school entry, in 1978. Since then, deaths from asthma(23) and other immune disorders have been rising (as has also the reported incidence of whooping cough itself!).

20 JAMA 1994;272 (8): pgs 592-3, and Lancet 1994:344:140.

21 Epidemiology 1997 Nov 8:6 678-80

22 J Allergy Clin Immunol 1999;104:1128-30. Dec 1999; 104 Number 6

23 CDC MMWR reports (See Appendix B in Submission article on this web site)

http://www.vaccinetruth.org/peanut_oil.htm

Reported pertussis infection and risk of atopy in 8- to 12-yr-old vaccinated and nonvaccinated children.

1. Original Article
Pediatric Allergy & Immunology. 19(1):46-52, February 2008.

Bernsen, Roos M. D. 1, 2; Nagelkerke, Nico J. D. 2; Thijs, Carel 3; van der Wouden, Johannes C. 1

Abstract:

Pertussis infection has been suspected to be a potential causal factor in the development of atopic disease because of the effect of pertussis immunization on specific IgE antibodies. Although several studies found a positive association between pertussis infection and atopic disorders, this relationship has not yet been studied in a population stratified by vaccination status. To assess the association between pertussis infection and atopic disorders in pertussis-unvaccinated children and in pertussis-vaccinated children. Using data from a previously conducted study on the relationship between the diphtheria-tetanus-pertussis-(inactivated) poliomyelitis vaccination in the first year of life and atopic disorders, the study population of 1872 8-12 yr old was divided into children pertussis-unvaccinated and children pertussis-vaccinated in the first year of life. Within each group, the association between pertussis infection and atopic disorders (both as reported by the parents) was assessed. In the unvaccinated group, there were no significant associations between pertussis infection and atopic disorders. In the vaccinated group, all associations between pertussis infection and atopic disorders were positive, the associations with asthma [odds ratio (OR) = 2.24, 95% confidence interval (CI95%): 1.36-3.70], hay fever (OR = 2.35, CI95%: 1.46-3.77) and food allergy (OR = 2.68, CI95%: 1.48-4.85) being significant. There was a positive association between pertussis infection and atopic disorders in the pertussis vaccinated group only.


http://www.mja.com.au/public/issues/184_04_200206/eld10500_fm.html

eMJA The Medical Journal of Australia

Pediatrics 1988 Jun (81) Supplement – Report on the Task Force on Pertussis and Pertussis Immunization – extract states, For more than 25 years, it has been known that pertussis vaccine is a reliable adjuvant for the production of experimental allergic encephalitis.

Bull Eur Physiopathol Respir 1987;23 Suppl 10:111s-113s

A model for experimental asthma: provocation in guinea-pigs immunized with Bordetella pertussis states, “ Guinea-pigs were sensitized with killed Bordetella pertussis………the presence of the immediate type of immune response was verified by passive cutaneous anaphylaxis……B. pertussis not only alters adrenergic function but provocation in B. pertussis-sensitized guinea-pigs seems to be a good model for bronchial asthma. PMID 2889487

Pediatr Res 1987 Sep;22(3):262-7

Murine responses to immunization with pertussis toxin and bovine serum albumin: I. Mortality observed after bovine albumin challenge is due to an anaphylactic reaction……….the results of our experiments have established that the disease induced by coimmunizing mice with Ptx and BSA is due to an immediate type hypersensitivity…………PMID 3309858


Infect Immun 1987 Apr.;55(4):1004-8

Anaphylaxis or so-called encephalopathy in mice sensitized to an antigen with the aid of pertussigen (pertussis toxin), states, Sensitization of mice with 1mg of bovine serum albumin (BSA) or chicken egg albumin (EA) ………….induced a high degree of anaphylactic sensitivity when the mice were challenged i.v. with 1 mg of antigen 14 days later. PMID 3557617

JAMA 1994 Aug 24-31;272(8):592-3

Pertussis vaccination and asthma: is there a link?

A study of 450 children, 11% of the children who had received the pertussis vaccination suffered from asthma, as compared with only 2% of the children who had not been vaccinated. [This does not tell you if the "unvaccinated children" had no vaccinations or just other vaccainations...- bfg] PMID 8057511

Allergy 1983 May;38(4):261-71

The non-specific enhancement of allergy. III. Precipitation of bronchial anaphylactic reactivity in primed rats by injection of alum or B. pertussis vaccine: relation of response capacity to IgE and IgG2a antibody levels. …..These results show that injection of alum or B. pertussis vaccine without antigen can precipitate/enhance anaphylactic response capacity and production of specific and non-specific IgE and IgG2a. PMID 6307077

Allergy 1980 Jan;35(1):65-71

Antigen-induced bronchial anaphylaxis in actively sensitized guinea pigs. Pattern of response in relation to immunization regimen….guinea-pigs sensitized with small amounts of antigen together with alum produced IgE and IgG1 antibodies. PMID 7369497

Allergy 1978 Jun:33(3):155-9

Aluminum phosphate but not calcium phosphate stimulates the specific IgE response in guinea pigs to tetanus toxoid. It is hypothesized that the regular application of aluminum compound-containing vaccines on the entire population could be one of the factors leading to the observed increase of allergic diseases. PMID 707792

Pediatr Allergy Immunol 1994 May;5(2):118-23

Immunoglobulin E and G responses to pertussis toxin after booster immunization in relation to atopy, local reactions and aluminum content of the vaccines. The role of aluminium for IgG and IgE responses to pertussis toxin (PT), as well as for side effects, was investigated in 49 children with known atopy status…the addition of aluminum to the pertussis vaccine was, thus, associated with a stronger IgG antibody response, but tended also to induce a stronger IgE antibody response. The correlation between total IgE and PT-IgE, which was most prominent in children with atopy, indicates that the role of immunization for the development of allergy merits further studies. PMID 8087191

Adv Drug Deliv Rev 1998 Jul 6;32(3):155-172

Entitled Aluminum compounds as vaccine adjuvants stated, “Limitations of aluminum adjuvants include local reactions, augmentation of IgE antibody responses, ineffectiveness for some antigens and inability to augment cell-mediated immune responses, especially cytotoxic T-Cell responses. PMID 10837642

Annals of Asthma, Allergy and Immunology, Vol. 85, Number 1, July 2000 article T-cell subsets (Th1 versus Th2) includes Figure 7 on page 15 – “Factors responsible for the imbalance of the Th1/Th2 responses which is partly responsible for the increased prevalence of allergy in Western countries. Risk for atopy – Th2, increased exposure to some allergens and Th2-biasing vaccines (alum as adjuvant).”

Immunology Today, March 1998, Volume 19, p. 113-116 states, “Modern vaccinations, fear of germs and obsession with hygiene are depriving the immune system of information input upon which it is dependent. This fails to maintain the correct cytokine balance and fine-tune T-cell regulation, and may lead to increased incidences of allergies and autoimmune diseases.”

From the journal Allergy 1999, 54, 398-399

Multiple Vaccination effects on atopy, “An increase in the incidence of childhood atopic diseases may be expected as a result of concurrent vaccination strategies that induce a Th2-biased immune response. What should be discussed is whether the prize of a reduction of common infectious diseases through a policy of mass vaccination from birth is worth the price of a higher prevalence of atopy.”

Journal of Manipulative and Physiological Therapeutics, Feb. 2000; 23(2):81-90

Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States, “The odds of having a history of asthma was twice as great among vaccinated subjects than among unvaccinated subjects. The odds of having any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects.” PMID 10714532

Thorax 1998 Nov;53(11):927-32

Early childhood infection and atopic disorder, stated “Interpretation of the prediction of atopic disorders by immunisation with wholecell pertussis vaccine and treatment with oral antibiotics needs to be very cautious because of the possibilities of confounding effects and reverse causation. However, plausible immune mechanisms are identifiable for the promotion of atopic disorders by both factors and further investigation of these association is warranted.” PMID 10193389

Epidemiology 1997 Nov;8(6):678-80

Is infant immunization a risk factor for childhood asthma or allergy? This study followed 1,265 children born in 1977. The 23 children who received no DPT and polio immunizations had no recorded asthma episodes or consultations for asthma or other allergic illness before age 10 years; in the immunized children, 23.1% had asthma episodes, 22.5% asthma consultations, and 30% consultations for other allergic illness. Similar differences were observed at ages 5 and 16 years. PMID 9345669


Arerugi 2000 Jul;49(7):585-92

The Effect of DPT and BCG vaccinations on atopic disorders findings include, “From these results we conclude that DPT vaccination has some effect in the promotion of atopic disorders……. PMID 10944825

CAN VACCINES CAUSE FOOD ALLERGIES?

JAMA 2001 Apr 4;285(13):1746-8

Detection of peanut allergens in breast milk of lactating women states, “Most individuals who react to peanuts do so on their first known exposure”……………..and concluded “Peanut protein is secreted into breast milk of lactating women following maternal dietary ingestion. Exposure to peanut protein during breastfeeding is a route of occult exposure that may result in sensitization of at-risk infants.” PMID 11277829

Women have been ingesting peanut protein while breastfeeding for decades. What has changed in the last 15 years to cause infants to develop life-threatening allergies to this legume? One change has been the vaccination schedule.

The Int Arch Allergy Immunol 1999 Jul; 119(3):205-11

Pertussis adjuvant prolongs intestinal hypersensitivity concludes: Our findings indicate nanogram quantities of PT (pertussis toxin), when administered with a food protein, result in long-term senitization to the antigen, and altered intestinal neuroimmune function. These data suggest that exposure to bacterial pathogens may prolong the normally transient immune responsiveness to inert food antigens. PMID 10436392

Does this study explain why babies and toddlers react on their first exposure to the peanuts or other antigens? The babies may have been sensitized by the vaccines to the proteins through breast milk or formula ingested at the time of vaccination. This would also explain why children are anaphylactic to a variety of proteins, such as different tree nuts, peanuts, egg, legumes, milk, seeds, etc., depending on what proteins the mother ate at the time of vaccination.

IS THE INTRODUCTION OF THE HIB VACCINE CONNECTED TO THE INCREASE IN FOOD ANAPHYLAXIS IN CHILDREN?

Rates of anaphylaxis have increased dramatically since the introduction of the Hib vaccine.

Clin Exp Pharmacol Physiol 1979 Mar-Apr;6(2):139-49

Comparison of vaccination of mice and rats with Haemophilus influenzae and Bordetella pertussis as models of atopy, states “The Haemophilus influenzae vaccinated experimental animal provides a model that is possibly more related to human atopy than the Bordetella pertussis vaccinated animal.” PMID 311260

Ann Allergy 1979 Jan;42(1):36-40

States “To determine whether Haemophilus influenzae could be a factor in human atopy its effects were studied on the (para-)Sympathic Cyclic nucleotide-histamine axis in rats. Haemophilus influenzae vaccination induced changes in the cholinergic system compatible with higher cyclic GMP levels and enhanced histamine release. The authors suggest an involvement of the cholinergic system in Haemophilus influenzae vaccination effects. PMID 216288

Agents Actions 1984 Oct;15(3-4):211-5 entitled Bronchial hyperreactivity to histamine induced by Haemophilus influenzae vaccination states “……This suggests a hyperreactivity of the parasympathethic, cholinergic pathways as a result of H.influenzae vaccination.” PMID 6335351


Eur J. Pharmacol 1980 Apr 4;62(4):261-8 entitled The effects of Haemophilus influenzae vaccination on anaphylactic mediator release and isoprenaline-induced inhibition of mediator release states “These results indicate an increased sensitivity to antigenic challenge and suggest that the functioning of beta-adrenoceptors was decreased as a result of H. Influenzae vaccination.” PMID 6154589

DOES THE PERTUSSIS VACCINE CAUSE ASTHMA, ALLERGIES AND ANAPHYLAXIS?


Pediatrics 1988 Jun (81) Supplement – Report on the Task Force on Pertussis and Pertussis Immunization – extract states, For more than 25 years, it has been known that pertussis vaccine is a reliable adjuvant for the production of experimental allergic encephalitis.4

Pediatr Res 1987 Sep;22(3):262-7

Murine responses to immunization with pertussis toxin and bovine serum albumin: I. Mortality observed after bovine albumin challenge is due to an anaphylactic reaction……….the results of our experiments have established that the disease induced by coimmunizing mice with Ptx and BSA is due to an immediate type hypersensitivity…………PMID 3309858

Infect Immun 1987 Apr.;55(4):1004-8

Anaphylaxis or so-called encephalopathy in mice sensitized to an antigen with the aid of pertussigen (pertussis toxin), states, Sensitization of mice with 1mg of bovine serum albumin (BSA) or chicken egg albumin (EA) ………….induced a high degree of anaphylactic sensitivity when the mice were challenged i.v. with 1 mg of antigen 14 days later. PMID 3557617

ARE MULTIPLE VACCINES CAUSING OUR IMMUNE SYSTEMS TO FAIL?

Immunology Today, March 1998, Volume 19, p. 113-116 states, “Modern vaccinations, fear of germs and obsession with hygiene are depriving the immune system of information input upon which it is dependent. This fails to maintain the correct cytokine balance and fine-tune T-cell regulation, and may lead to increased incidences of allergies and autoimmune diseases.”

From the journal Allergy 1999, 54, 398-399

Multiple Vaccination effects on atopy, “An increase in the incidence of childhood atopic diseases may be expected as a result of concurrent vaccination strategies that induce a Th2-biased immune response. What should be discussed is whether the prize of a reduction of common infectious diseases through a policy of mass vaccination from birth is worth the price of a higher prevalence of atopy.”

Journal of Manipulative and Physiological Therapeutics, Feb. 2000; 23(2):81-90

Effects of diphtheria-tetanus-pertussis or tetanus vaccination on allergies and allergy-related respiratory symptoms among children and adolescents in the United States, “The odds of having a history of asthma was twice as great among vaccinated subjects than among unvaccinated subjects. The odds of having any allergy-related respiratory symptom in the past 12 months was 63% greater among vaccinated subjects than unvaccinated subjects.” PMID 10714532

Thorax 1998 Nov;53(11):927-32

Early childhood infection and atopic disorder, stated “Interpretation of the prediction of atopic disorders by immunisation with wholecell pertussis vaccine and treatment with oral antibiotics needs to be very cautious because of the possibilities of confounding effects and reverse causation. However, plausible immune mechanisms are identifiable for the promotion of atopic disorders by both factors and further investigation of these association is warranted.” PMID 10193389

Epidemiology 1997 Nov;8(6):678-80

Is infant immunization a risk factor for childhood asthma or allergy? This study followed 1,265 children born in 1977. The 23 children who received no DPT and polio immunizations had no recorded asthma episodes or consultations for asthma or other allergic illness before age 10 years; in the immunized children, 23.1% had asthma episodes, 22.5% asthma consultations, and 30% consultations for other allergic illness. Similar differences were observed at ages 5 and 16 years. PMID 9345669

Arerugi 2000 Jul;49(7):585-92

The Effect of DPT and BCG vaccinations on atopic disorders findings include, “From these results we conclude that DPT vaccination has some effect in the promotion of atopic disorders……. PMID 10944825

http://drgreene.mediwire.com/main/Default.aspx?P=Content&ArticleID=111728

Of the 1.9 billion doses of vaccines administered in the United States between 1991 and 2001, only 2,281 cases of allergic reactions were reported.1

(which means there were really 20,000 - 200,000 because doctors only report 1-10% of all adverse reactions to VAERS as admitted by the CDC and FDA)

Local allergic reaction to a vaccine may consist of a wheal and flare or localized urticaria at the injection site. Systemic allergic reactions may be classified as non-life-threatening or life-threatening. Non-life-threatening systemic reactions such as generalized urticaria may follow DTaP, DT, and dT administration. Transient petechiae or urticaria following DPT vaccination usually occurs within minutes and may be caused by preformed circulating antibodies to diphtheria and tetanus. Transient generalized urticaria following a vaccine is not a contraindication to further vaccination.7

An Arthus reaction is a severe local reaction with warmth, erythema, edema, petechiae, or ulceration usually occurring two to eight hours after vaccination. This reaction occurs secondary to the presence of a high level of preformed antibody in a previously vaccinated patient, and most commonly follows diphtheria and tetanus toxoid injection. For this reason, these booster vaccines should not be given more often than every 10 years,8 although, in cases of tetanus exposure, a booster injection for tetanus may be given if more than five years have passed since the last dose.

Anaphylactic reactions are life-threatening systemic allergic reactions that may manifest as hypotension, bronchospasm, generalized urticaria, angioedema, and laryngeal edema. An estimated two cases of anaphylaxis occur for every 100,000 DPT injections administered; the rate of anaphylaxis after DTaP vaccination is unknown. Anaphylaxis to hepatitis B vaccine has been estimated to occur in one of every 600,000 recipients, most of whom are adults.4 Eleven reports of anaphylaxis secondary to MMR vaccination (after 70 million MMR doses administered) have been received by VAERS.9 The frequency of anaphylaxis to tetanus toxoid is 1.6 for every million doses given.10 For all vaccines, a true anaphylactic reaction is an absolute contraindication to further immunization with that vaccine.

It is important to differentiate other, more common, nonallergic clinical syndromes from anaphylactic vaccine reactions. Vasovagal reactions with pallor, bradycardia, weakness, dizziness, and brief syncope may occur five to 15 minutes after vaccination. These reactions occur more often in adolescents and adults than in children. Over 2,000 reports of vaccine-associated syncope were received by VAERS from 1990–2001.3 A hypotonic–hyporesponsive episode (HHE) is a shock-like syndrome, occurring 10 to 48 hours after vaccination, marked by sudden loss of muscle tone, pallor, fever, and unresponsiveness. HHE has been described following whole cell pertussis vaccine and is considered a relative contraindication (the physician should weigh the benefit against the risk in determining whether to administer the vaccine) to pertussis revaccination.9

Allergic reactions to pneumococcal, Hib, hepatitis B, hepatitis A, and poliovirus vaccines occur very rarely. Allergic reactions to any vaccine may occur secondary to the vaccine antigen itself or to other vaccine components. IgE antibodies to tetanus or diphtheria toxoids have been detected in the sera of patients experiencing generalized urticaria or anaphylaxis to vaccines containing these toxoids.11

Because the live attenuated viruses used in MMR vaccine are grown in cultured chick embryo fibroblasts, minute amounts of the egg protein ovalbumin (<1 nanogram) are contained in the final vaccine preparation. Before 1997, the American Academy of Pediatrics (AAP) recommended that patients with a history of egg anaphylaxis undergo skin testing with the MMR vaccine.12 Positive skin tests would necessitate vaccine desensitization via a graded dose protocol. These recommendations were revised in 1997 after numerous reports of safe administration of MMR vaccine to children allergic to eggs.13–17 Skin testing is no longer required for egg-allergic individuals.

Instead, MMR may be routinely administered to egg-allergic children with the precaution that vaccine recipients be observed for 90 minutes post-vaccination in a facility equipped to treat vaccine anaphylaxis.18 Allergic reactions to MMR vaccine have occurred in children who are not allergic to eggs and may also be caused by sensitivity to neomycin or gelatin, both of which are contained in the vaccine. Khakoo has suggested that children with egg allergy and asthma may be at increased risk of adverse MMR reactions.19

The influenza virus vaccine contains greater amounts of ovalbumin than does the MMR vaccine, because the virus utilized in the vaccine is derived from the allantoic fluids of infected chick embryos. Generally, influenza virus vaccine is contraindicated in any child with a history of egg anaphylaxis. A recent study, however, included a protocol for relatively safe administration of influenza virus vaccine to egg-allergic individuals.20

Egg protein is also contained within the monovalent measles, monovalent mumps, yellow fever, and rabies vaccines, but not within monovalent rubella vaccine.
Stabilizers are added to vaccines to stabilize the vaccine antigen. Porcine gelatin is the stabilizer contained within MMR and its component vaccines and in varicella, viral influenza, yellow fever, Japanese encephalitis, and DTaP vaccines (Table 4).

Patients reporting clinical gelatin allergy have usually reacted to the bovine gelatin contained in foods. These patients may be at risk of allergic reactions following administration of gelatin-containing vaccines.24 It is possible that many reactions previously attributed to egg allergy in MMR recipients were due to gelatin allergy. IgE antibodies to gelatin were detected in 93% of patients reporting anaphylaxis to the monovalent measles, mumps, and rubella vaccines in Japan.25

Adjuvants are generally utilized in vaccines that contain killed microbes or toxoids. The aluminum-adsorbed vaccines DTaP, DT, Td, hepatitis A, and hepatitis B are adjuvant-containing vaccines. Administration of such vaccines may cause subcutaneous nodules that persist for weeks or months.4 Pain and tenderness at the injection site have also been attributed to aluminum contained in various vaccine preparations.

Current hepatitis B vaccines are prepared from yeast cultures. Yeast hypersensitivity is an absolute contraindication for hepatitis B vaccine administration.26

Allergy to chicken, duck, or feathers is not a contraindication to any routine pediatric vaccine.

The potential reactivity of latex-sensitive individuals to the latex contained in the rubber stoppers of vaccine vials is a concern. However, most vaccine vials contain synthetic rubber rather than the natural rubber latex associated with clinical reactivity.

Avoiding allergic reactions: Pre-vaccination screening

All patients should be screened before vaccine administration for any possible contraindications to vaccination (see the Key Points box). In addition to obtaining a detailed patient history for any food allergies (egg or gelatin) or drug allergies (such as to neomycin, polymyxin B, streptomycin), it is important to screen all vaccine recipients for a history of vaccine reactions. Revaccination is contraindicated in any patient reporting prior anaphylaxis to a vaccine or vaccine component.