Tag: ingredients

Vaccine Allergies

The Cervarix HPV vaccine lists latex as an ingredient - in the tip caps.
Cervarix tip caps contain natural rubber latex and can be a problem if your child has an anaphylactic reaction to latex.

Can you be allergic to a vaccine?

Of course.

In fact, having a severe, life-threatening allergy to a vaccine is one of the main reasons to not get vaccinated.

Specifically, guidelines usually state that you should not get vaccinated:

  • if you have a severe allergy to any component of the vaccine
  • if you have had had a serious allergic reaction to a previous dose of the vaccine

Fortunately, these types of serious allergic reactions are very rare. In fact, most kids with egg allergies can even get a flu shot, something unheard of just a few years ago.

How rare?

The WHO states that “The rate of anaphylaxis has been documented to be variable, with a rate of 3.5 to 10 per million doses following a measles-containing vaccine.”

Rates of 0.65 to 1.53 cases per million doses have also been reported when including more commonly used vaccines.

Vaccine Allergy Myths

Still, instead of true vaccine allergies leading to problems, it is much more common for misinformation about vaccine allergies to scare parents away from getting their kids vaccinated.

Some of the most common vaccine allergy myths include that:

  • you can’t get vaccinated if you have a history of a penicillin allergy, cephalosporin allergy, or sulfa drug allergy – you can
  • you can’t get vaccinated if you have non-vaccine allergies, have relatives with allergies, or are receiving allergy shots – you can
  • you can’t get vaccinated if you have a latex allergy that is not anaphylactic – you can
  • you can’t get the MMR vaccine if you have an egg allergy – you can
  • you can’t get the flu vaccine if you have an egg allergy – you can, although your pediatrician will observe your child for 30 minutes if he has a severe egg allergy
  • vaccines are causing a peanut allergy epidemic – they aren’t and you can get vaccinated if you have a peanut allergy.

And know that vaccines don’t actually cause allergies.

Allergies and Vaccine Components

Components of vaccines can rarely trigger allergic reactions, including:

  • antibiotics – but these aren’t antibiotics that are commonly used anymore, like Amoxil. Instead, some vaccines contain residual amounts of either gentamicin, neomycin, polymyxin B, or streptomycin. And anyway, the small amounts that could be leftover in the vaccine aren’t known to trigger allergic reactions.
  • eggs – while your child with an egg allergy can get the flu shot, and then being observed as a precaution, the yellow fever vaccine could still be an issue
  • gelatin – some vaccines use gelatin, like in Jell-O, as a stabilizer
  • latex – if your child has a severe (anaphylactic) allergy to latex, you should likely avoid vaccines supplied in vials or syringes that contain natural rubber latex
  • yeast – although they aren’t thought to be an issue for kids with yeast allergies, a few vaccines can have residual amounts of yeast in them

What about aluminum? Some recent studies, including one in Pediatrics, “Case Report of Subcutaneous Nodules and Sterile Abscesses Due to Delayed Type Hypersensitivity to Aluminum-Containing Vaccines,” do suggest that aluminum can very rarely cause a non-anaphylactic delayed type IV hypersensitivity reaction. These children could have persistent redness and nodules at the site of vaccination for weeks or months when an aluminum containing vaccine is given.

Fortunately, these are mild, non-life-threatening reactions and aren’t a reason to stop vaccinating your child. And, as another study reported, “Unexpected loss of contact allergy to aluminum induced by vaccine,” many of these children outgrow their allergy.

Keep in mind that persistent hard nodules can also be caused by irritation and may not be an allergic reaction at all.

What To Know About Vaccine Allergies

The 2011 IOM report, “Adverse Effects of Vaccines: Evidence and Causality,” while concluding that most vaccines, including MMR, varicella, flu, hepatitis B, tetanus, meningococcal, and HPV could cause anaphylaxis,  stated that “It appears likely to the committee that the risk of anaphylaxis caused by vaccines is exceedingly low in the general population.”

Do you think that your child has an allergy keeping him from getting vaccinated?

Talk to your pediatrician or a pediatric allergist. They can review the “Algorithm for treatment of patients with hypersensitivity reactions after vaccines,” which “provides a rational and organized approach for the evaluation and treatment of patients with suspected hypersensitivity.”

This is especially important if you think that your child is allergic to all vaccines, something that is almost unheard of, as vaccines have different components and are made in different ways.

For More Information on Vaccine Allergies

Vaccines and Egg Allergies

Which vaccines do you have to skip if you are allergic to eggs?

Many people are surprised that the answer is that you probably don’t have to skip any vaccines.

Although some vaccines are made in eggs and may contain residual egg proteins, the latest studies show that they can safely be given to kids with egg allergies.

That wasn’t always the case though.

Some pediatricians and parents likely still remember when the recommendation for the MMR vaccine was that:

  • Persons with a history of anaphylactic reactions (hives, swelling of the mouth and throat, difficulty in breathing, hypotension, and shock) following egg ingestion should be vaccinated only with extreme caution.(1989 MMR recommendation)

Of course, now, experts say that “Although measles and mumps components of the vaccine are grown in chick embryo fibroblast tissue culture, allergy to egg is not a contraindication to vaccination.”

Similarly, the warnings and recommendations about egg allergies and flu vaccines have changes over the years. From previous warnings about avoiding the flu vaccine, experts now say that:

  • Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive flu vaccine.
  • Persons with a history of a severe egg allergy can still get a flu vaccine, but they should be vaccinated “in an inpatient or outpatient medical setting (including, but not necessarily limited to hospitals, clinics, health departments, and physician offices). Vaccine administration should be supervised by a health care provider who is able to recognize and manage severe allergic conditions.”

Recommendations about the yellow fever vaccine haven’t changed though. Talk to your pediatrician if your child has an egg allergy and needs the yellow fever vaccine for travel. You will likely need to see an allergist to get vaccinated.

For More Information on Vaccines and Egg Allergies:

 

References for Vaccines and Egg Allergies:
Measles Prevention: Recommendations of the Immunization Practices Advisory Committee (ACIP) . December 29, 1989 / 38(S-9);1-18.

Fetal Bovine Serum in Vaccines

Are you worried about fetal bovine serum in vaccines?

Are you wondering why they put fetal bovine serum in vaccines?

Well, it is not really added to the vaccine, like a preservative.

Instead, the CDC explains why fetal bovine serum may be in some vaccines:

In the manufacture of viral vaccines, the virus may be grown in cells.  These cells need a source of nutrition, which in some instances may be provided by fetal bovine serum.

So fetal bovine serum is used as a growth media. And it is eventually removed.

There is no risk that using these materials from cows could cause mad-cow disease.

For more information:

Latex Allergies and Vaccines

Can you get vaccines if you have a latex allergy?

“Dry, natural rubber is used in the tip of syringe plungers, the tip on prefilled syringes, vial stoppers,” and could cause a problem for some people with latex allergies.

According to the CDC:

If a person reports a severe (anaphylactic) allergy to latex, vaccines supplied in vials or syringes that contain natural rubber latex should not be administered unless the benefit of vaccination clearly outweighs the risk for a potential allergic reaction. In these cases, providers should be prepared to treat patients who are having an allergic reaction.

For latex allergies other than anaphylactic allergies (e.g., a history of contact allergy to latex gloves), vaccines supplied in vials or syringes that contain dry, natural rubber or natural rubber latex may be administered.

Many vaccines use synthetic rubber or synthetic latex though, so getting vaccinated with one of these vaccines would be a good alternative if your child has a severe allergy to latex.

Keep in mind that you aren’t supposed to simply remove the latex stopper from a vaccine vial to try and avoid triggering an anaphylactic reaction. That did work for one patient in the case report “Anaphylaxis after hepatitis B vaccination.” She got her second dose using “rubber free technique” and didn’t have a reaction.

Still, latex allergies with vaccines doesn’t seem to be a big problem.

One study “Vaccination of persons allergic to latex: a review of safety data in the Vaccine Adverse Event Reporting System (VAERS),” in the journal Vaccine “revealed only 28 cases of possible immediate-type hypersensitivity reactions in vaccine recipients with a history of allergy to latex.” And only two of those required hospitalization.

For more information:

Vaccines with Diluents

Many vaccines come in prefilled syringes or ready to use multi-dose vials.

Others are freeze dried and need to reconstituted or mixed with a specific diluent, such as sterile water.

Those that use a diluent include:

  • MMR II
  • ProQuad
  • Varivax (chickenpox)
  • Zostavax (shingles)
  • ActHib and TriHIBit (Hib)
  • Hiberix
  • Menveo and Menomune (Meningococcal)
  • Pentacel
  • Rotarix
  • Imovax and RabAvert (rabies)
  • YF-VAX (yellow fever)

In addition to sterile water, vaccine diluents can include sodium chloride, distilled water, and vaccine antigens.

The use of diluents can lead to errors when administering vaccines, from using the wrong diluent, using a drug instead of a diluent, to giving a diluent instead of a vaccine.

That’s what happened when 15 children in Syria died after being vaccinated with MMR. The drug Atracurium was used instead of the diluent for the MMR vaccine.

And that’s why people who give vaccines are taught to “Check the vial label three times to be sure you have chosen the correct vaccine product (and diluent, when applicable). Check the expiration date of the vaccine (and diluent) before using to be sure they are not out of date.”

For more information:

Paracelsus

Paracelsus (1493–1541) lived well before the age of vaccines.

He is though often thought of as the father of toxicology, famously saying that:

Solely the dose determines that a thing is not a poison

This principle continues to be used today, helping to point out that small amounts of chemicals in vaccines are not toxic or poisonous.

For more information:

Acellular Pertussis Vaccines

The current acellular pertussis vaccines include DTaP and Tdap.

While the first pertussis vaccine actually used inactivated Bordetella pertussis cells, this type of whole cell vaccine was thought to cause too many side effects.

The whole cell pertussis vaccine (DTP) began to be replaced with the acellular pertussis vaccine in 1996. These DTaP vaccines use purified, inactivated components of Bordetella pertussis cells.

The Tdap formulations were added for teens and adults in 2005. It actually contains less of the diphtheria component than the pediatric formulation.

Unfortunately, these new vaccines don’t work as well as the ones they were made to replace, leading to waning immunity and contributing to our pertussis outbreaks.

And even more tragically, we may not have needed to replace them in the first place.

It turns out that many of the serious vaccine injuries that were supposedly caused by the DTP vaccine actually weren’t. From multiple lawsuits in England that found the DTP vaccine did not cause seizures or brain damage to the discovery of Dravet syndrome, the whole cell pertussis vaccine likely could be safely reintroduced.

For more information: