Abs Curr Opin Otolaryngol Head Neck Surg. 2004 12(3) 223-31
Vaccination and
allergy.
Rottem M, Shoenfeld Y.
Division
of Allergy and Clinical Immunology, Ha'Emek Medical Center, Afula,
Israel.
PURPOSE OF REVIEW: Vaccines have had a major effect on
controlling the spread of infectious diseases, but use of certain
vaccines was linked to potential allergic and autoimmune side effects in
healthy and often in certain high-risk populations. In this review the
authors summarize the current knowledge of such risks. RECENT FINDINGS:
Immediate systemic allergic reactions after vaccination with commonly
used vaccines are extremely rare. Use of certain vaccines was linked to
potential allergic side effects in healthy and often in certain
high-risk populations. The authors review the data on the risk
associated with important vaccines including influenza, smallpox,
pneumococcus, Japanese encephalitis, Bacille Calmette-Guerin, pertussis,
and measles, mumps, and rubella. Two main components were identified as
a source for allergic reactions in vaccines: gelatin and egg protein.
There is growing interest in the potential interactions between infant
vaccination and risk for development of atopic disease. In addition,
there is concern that genetic risk for atopy influences capacity to
respond to vaccination during infancy. There is no evidence that
vaccines such as Bacille Calmette-Guerin; pertussis; influenza; measles,
mumps, and rubella; or smallpox have an effect on the risk of the
development of atopy later in life. Immunotherapy provides an
efficacious and safe method for the treatment of allergic conditions by
immunomodulation of the immune system. The possibility of vaccination
triggering or unmasking autoimmunity in genetically susceptible
individuals cannot be ruled out, but for the general population the
risk-to-benefit ratio is overwhelmingly in favor of vaccinations.
SUMMARY: Childhood vaccination remains an essential part of child health
programs and should not be withheld, even from children predisposed to
allergy. Vaccinations are safe, but special attention should be taken in
high-risk individuals with anaphylactic reactions to foods, and in
patients with autoimmune diseases.