Chiu Chia-Yu, Henao-Martínez Andrés F, Agudelo Higuita Nelson Iván
Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA.
Department of Medicine, Division of Infectious Diseases, University of Colorado, Aurora, CO, USA.
Ticks Tick Borne Dis. 2025 Aug 1;16(5):102532. doi: 10.1016/j.ttbdis.2025.102532.
Alpha-gal syndrome (AGS) is an allergic reaction caused by sensitization to alpha-gal, a sugar molecule in gelatin-containing vaccines. Tick bites can induce alpha-gal IgE sensitization, as ticks inject alpha-gal through their saliva. However, there is no real-world data on the anaphylaxis rates associated with gelatin-containing vaccines in patients with tick bite history. We utilized TriNetX, a research network database, to analyze data in November 2024. The history of tick bites (i.e., the presence of a tick-bite history) was categorized into three groups: ehrlichiosis, tularemia, and bites from nonvenomous arthropods. Vaccines were classified into two categories: (1) gelatin-containing vaccines (live intranasal influenza [FluMist], varicella, measles/mumps/rubella [MMR], oral typhoid, rabies [RabAvert], and yellow fever vaccines [YF-VAX]) and (2) gelatin-free vaccines. Anaphylactic episodes were identified in patients with a history of tick bites who developed anaphylaxis within one day following vaccination. The anaphylaxis rates after receiving gelatin-containing vaccines were 0.06 %, 0.7 %, and 0.2 % in patients with ehrlichiosis, tularemia, and nonvenomous arthropod bites, respectively. In contrast, the anaphylaxis rates after receiving gelatin-free vaccines were 0.04 %, 0.0 %, and 0.1 % in patients with ehrlichiosis, tularemia, and nonvenomous arthropod bites, respectively. Among the gelatin-containing vaccines, live intranasal influenza and varicella vaccines posed a higher rate of anaphylaxis compared to other gelatin-containing vaccines. While tick bites are associated with AGS, a history of tick bites is not a contraindication for most gelatin-containing vaccines, including MMR, oral typhoid, rabies, and yellow fever vaccines. Further investigations are warranted to evaluate the safety of intranasal influenza and varicella vaccines in this population.
α-半乳糖综合征（AGS）是一种由对α-半乳糖致敏引起的过敏反应，α-半乳糖是含明胶疫苗中的一种糖分子。蜱虫叮咬可诱导α-半乳糖IgE致敏，因为蜱虫会通过唾液注入α-半乳糖。然而，对于有蜱虫叮咬史的患者，含明胶疫苗相关的过敏反应发生率尚无实际数据。我们利用TriNetX（一个研究网络数据库）在2024年11月进行数据分析。蜱虫叮咬史（即存在蜱虫叮咬史）分为三组：埃立克体病、兔热病和无毒节肢动物叮咬。疫苗分为两类：（1）含明胶疫苗（鼻内减毒活流感疫苗[FluMist]、水痘疫苗、麻疹/腮腺炎/风疹疫苗[MMR]、口服伤寒疫苗、狂犬病疫苗[RabAvert]和黄热病疫苗[YF-VAX]）和（2）不含明胶疫苗。在有蜱虫叮咬史且在接种疫苗后一天内发生过敏反应的患者中识别出过敏发作情况。埃立克体病、兔热病和无毒节肢动物叮咬患者接种含明胶疫苗后的过敏反应发生率分别为0.06%、0.7%和0.2%。相比之下，埃立克体病、兔热病和无毒节肢动物叮咬患者接种不含明胶疫苗后的过敏反应发生率分别为0.04%、0.0%和0.1%。在含明胶疫苗中，鼻内减毒活流感疫苗和水痘疫苗的过敏反应发生率高于其他含明胶疫苗。虽然蜱虫叮咬与AGS有关，但蜱虫叮咬史并非大多数含明胶疫苗（包括MMR、口服伤寒疫苗、狂犬病疫苗和黄热病疫苗）的接种禁忌证。有必要进一步研究评估该人群中鼻内减毒活流感疫苗和水痘疫苗的安全性。
