Turkalj Mirjana, Erceg Damir
Djecja bolnica Srebrnjak, Zagreb.
Lijec Vjesn. 2012 May-Jun;134(5-6):173-7.
Allergic reactions after vaccination are very rare. Even if the vaccine is not clearly the cause of possible side effects, including possible allergic reactions occurring after vaccine administration, they should be reported to the appropriate authorized body. Allergic reaction occuring to other vaccine components are more likely than to the active agent, for instance to gelatine, egg protein, chicken protein, dextran, thimerosal, antimicrobials, etc. All patients with suspected allergy to vaccine components should be evaluated by an allergist. Immediate-type allergy skin testing should be performed in patients who appear to have had an allergic reaction after vaccination. This testing should help confirm that the reaction was IgE mediated and identify the responsible vaccine component. If the skin test result is negative, it is extremely unlikely that the patient will develop an allergic reaction and the patient can be vaccinated. In patients with suggestive history and positive skin tests results to vaccine components, the clinician can consider administering the alternative vaccine or the same vaccine in graded doses while observing the patient. Mild local reactions, fever, and other constitutional symptoms after vaccinations are not contraindications to subsequent doses.
疫苗接种后的过敏反应非常罕见。即便疫苗并非可能出现的副作用(包括疫苗接种后发生的可能过敏反应)的明确病因,也应向适当的授权机构报告这些情况。对疫苗其他成分发生过敏反应的可能性高于对活性成分的反应,例如对明胶、鸡蛋蛋白、鸡肉蛋白、右旋糖酐、硫柳汞、抗菌剂等过敏。所有疑似对疫苗成分过敏的患者都应由过敏症专科医生进行评估。对于接种疫苗后似乎发生了过敏反应的患者,应进行速发型过敏皮肤试验。此项检测应有助于确认该反应是否由IgE介导,并识别出引发反应的疫苗成分。如果皮肤试验结果为阴性,患者极不可能发生过敏反应,可进行疫苗接种。对于有提示性病史且对疫苗成分皮肤试验结果呈阳性的患者,临床医生可考虑给予替代疫苗或分次给予相同疫苗,同时对患者进行观察。接种疫苗后的轻度局部反应、发热及其他全身症状并非后续接种剂量的禁忌证。