Allergic reactions to
measles-mumps-rubella vaccination.
Patja A,
Makinen-Kiljunen S, Davidkin I, Paunio M, Peltola H.
Hospital
for Children and Adolescents, Helsinki University Central Hospital,
Finland. annamari.patja@hus.fi
OBJECTIVE: Immunization of
egg-allergic children against measles, mumps, and rubella (MMR) is often
deferred or even denied, although the safety of this vaccination has
been clearly shown. Moreover, the majority of severe allergic reactions
have occurred in egg-tolerant vaccinees. Other allergenic vaccine
components have been sought, and gelatin has been suggested as one cause
of allergic adverse events. The aim of this study was to further
characterize the actual allergenic vaccine components. METHODS: Serum
samples from 36 recipients of MMR vaccine with anaphylaxis, urticaria
with or without angioedema, asthmatic symptoms, or Henoch-Schonlein
purpura were analyzed by CAP System radioallergosorbent test (RAST) and
immunospot methods to detect the allergenic vaccine component. To
evaluate the correspondence between the findings in the CAP System RAST
or the immunospot and clinical symptoms, histories of allergies and
present hypersensitivity symptoms were assessed. RESULTS: Of the 36
participants, 10 were demonstrated to be allergic to gelatin. Seven of
them had persistent allergic symptoms, possibly attributable to foods
containing gelatin or cross-reactive allergens. The results of the
immunospot suggested concomitant allergy to gelatin and egg, chicken,
and feathers, as well as cow's milk, or they reflected allergen
cross-reactivity. CONCLUSIONS: Although severe allergic adverse events
attributable to MMR vaccination are extremely rare, all serious allergic
reactions should be further assessed to detect the likely causative
vaccine component, including gelatin. The current recommendation for
immunization of egg-allergic persons according to standard MMR
vaccination schedules is reinforced. measles, mumps, and rubella
vaccine, immunization, adverse effects, allergic reactions, gelatin
allergy, CAP System, radioallergosorbent test, immunospot,
immunoglobulin E.