Immunization Reactions

Schuval S: Avoiding allergic reactions to childhood vaccines (and what to do when they occur).Contemp Pediatr 2003; 20(4):29-53.

A child born in 2002 will receive 23 immunizations for 11 different diseases during the first 6 years. Over a 2-year period, 1.9 billion doses of vaccines were administered and 2,281 cases of allergic reactions were reported. This article examines what is in a vaccine, lists vaccines that contain egg protein, thimerosal, antibiotics, and gelatin. The authors review allergic and nonallergic reactions, how to screen before the vaccination, how to manage allergic reactions, and offer suggestions on revaccination.

All offices administering vaccines should contain medical emergency equipment: bag mask ventilators, intravenous catheters, intravenous fluid tubing, laryngoscopes, endotracheal tubes, oral airways, and oxygen. Children with significant allergic reactions should have serologic testing before further doses, and some suggest in-hospital vaccination. Although allergic reactions to vaccines are rare, it is important to screen for those children at risk for serious complications.