Immunology Unit, Borgo Roma University Hospital, Verona, Italy.
Green Channel Consultancy Clinic for Vaccine Adverse Event Prevention and Surveillance, Verona, Italy.
Pediatr Allergy Immunol. 2023 Jun;34(6):e13967. doi: 10.1111/pai.13967.
Currently available vaccines are safe, but, potentially, any vaccine can cause an allergic reaction and, albeit very rare, anaphylaxis can occur. Although its rarity, the precise diagnostic management of a suspected anaphylaxis postvaccination is of paramount importance due to the risk of a potentially serious reaction after re-exposure, while a misdiagnosis might lead to an increase in the number of children that interrupt vaccinations resulting in an unjustifiably individual and collective risk of loss of protection against immune preventable diseases. In the light that most cases of suspected allergy to a vaccine are not effectively confirmed in up to 85% of the cases referred for an allergy evaluation, patients can continue the vaccination schedule with the same formulation and tolerance of the booster doses. The patient assessment has to be done by an expert in the vaccine field, usually an allergist or an immunologist depending on the country, to select subjects at risk of allergic reactions and to perform the correct procedures for vaccine hypersensitivity diagnosis and management, in order to guarantee safe immunization practices. The aim of this review is to provide a practical guidance for the safe management of allergic children undergoing immunization procedures. The guide is referred both to the evaluation of children who have previously experienced a suspected allergic reaction to a specific vaccine and their management in case of further booster doses, and to children allergic to a component of the vaccine to be administered.
目前可用的疫苗是安全的，但任何疫苗都有可能引起过敏反应，尽管非常罕见，但仍有可能发生过敏反应。尽管其发生率很低，但由于再次暴露后可能发生潜在严重反应的风险，对疑似疫苗接种后过敏反应进行精确诊断管理至关重要，而误诊可能导致更多儿童中断疫苗接种，从而导致不必要的个人和集体免疫预防疾病的保护丧失风险。鉴于多达 85%的过敏评估转介病例中，疑似疫苗过敏的大多数病例无法得到有效证实，患者可以继续使用相同配方和增强剂量的疫苗接种计划。患者评估必须由疫苗领域的专家进行，通常是过敏症专家或免疫学家，具体取决于国家，以选择有过敏反应风险的受试者，并进行疫苗过敏诊断和管理的正确程序，以保证安全的免疫接种实践。本综述的目的是为接受免疫接种程序的过敏儿童的安全管理提供实用指南。该指南既适用于先前对特定疫苗发生疑似过敏反应的儿童的评估及其进一步增强剂量的管理，也适用于对要接种疫苗的疫苗成分过敏的儿童。
