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Available from: Stuart Carr, May 11, 2015
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    ABSTRACT: Anaphylactic reactions to vaccines are rare but do occur, and have been reported for nearly every vaccine. And while the reaction rate per each dose of vaccine is low, this is a common clinical question due in large part to the enormous numbers of vaccines administered. Reactions are most often due to vaccine constituents rather than the microbial components of the vaccine, but in many instances, the specific ingredient triggering the reaction cannot be definitively identified. Evaluation of patients with suspected vaccine reactions should begin by determining whether the symptoms and timing of the reaction were consistent with a true allergic reaction, followed by an assessment to determine whether the patient needs further doses of the vaccine in question, or similar vaccines, in the future. Skin and serologic testing to vaccines and vaccine constituents can then be performed to further assess the potential cause of the reaction and to develop a plan for future immunizations. Specific guidelines for the administration of influenza vaccines to egg allergic patients have been revised to allow virtually all patients to receive this vaccine in a straightforward manner.
    Pediatric Allergy and Immunology 09/2013; 24(6). DOI:10.1111/pai.12102 · 3.86 Impact Factor
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    ABSTRACT: The most serious form of type I or IgE-mediated hypersensitivity reaction is anaphylaxis. A standardized case definition of anaphylaxis as an adverse event after immunization has been developed. Such reactions to vaccines, including influenza vaccine, are rare but potentially life-threatening. Until recently, all influenza vaccines were manufactured in eggs. Residual egg protein in the vaccines was thought to pose a risk to egg-allergic vaccine recipients. However, a large number of recent studies have demonstrated that egg-allergic recipients are no more likely than those without egg allergy to suffer such reactions. Published guidelines have been updated to recommend that patients with egg allergy receive annual influenza vaccination. Any patient who has an anaphylactic reaction to influenza vaccine should be carefully evaluated by an allergist for guidance on subsequent immunization.
    Expert Review of Vaccines 06/2014; DOI:10.1586/14760584.2014.933079 · 4.22 Impact Factor
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    ABSTRACT: Most children with a history of penicillin allergy are labeled allergic and denied treatment with penicillin and sometimes other beta-lactam antibiotics. Most of these children never were or are no longer allergic to penicillin. Penicillin skin testing and oral challenge can identify patients who are not currently allergic, allowing them to be treated with penicillin. Children with egg allergy are often denied influenza vaccination, because the vaccine contains a small amount of egg protein. However, recent studies have demonstrated that children with even severe egg allergy can safely receive the vaccine, reducing their risk of the morbidity and mortality associated with influenza. Copyright © 2015 Elsevier Inc. All rights reserved.
    Immunology and Allergy Clinics of North America 11/2014; 35(1). DOI:10.1016/j.iac.2014.09.013 · 2.22 Impact Factor