A review of a paediatric emergency department vaccination programme for patients at risk of allergy/anaphylaxis

Cronin, John J.; Scorr, Annemarie; Russell, Sinead; McCoy, S; Walsh, Simon J.; O’Sullivan, Ronan

doi:10.1111/j.1651-2227.2012.02737.x

Cited by 20 publications

(13 citation statements)

References 19 publications

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“…These types of vaccine-related AEs are well described in the immunization literature, with a reported incidence around 10% for local reactions and around 5–15% for systemic ones. In addition, the incidence of AEs after revaccination at our SIS-PED was similar to that reported in other studies [ 11 , 19 ]. The Padua SIS-PED may prove useful in assessing and ensuring post-marketing vaccine safety among vaccination subsequent to a vaccine-related AE.…”

Section: Discussionsupporting

confidence: 90%

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Special Immunization Service: A 14-year experience in Italy

Donà¹,

Masiero²,

Brisotto³

et al. 2018

PLoS ONE

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BackgroundConcerns regarding vaccine safety are increasing along with lack of compliance to vaccination schedules. This study aimed to assess vaccination-related risks and the impact of a Special Immunization Service (SIS) at the Pediatric Emergency Department (PED) of Padua on vaccination compliance among participants.Materials and methodsThis retrospective cohort study included all children attending the SIS from January 1st 2002 to December 31st 2015. The Service is divided into a clinic (SIS-C) where all referred children undergo a pre-vaccination visit and an area within the Pediatric Emergency Department (SIS-PED) where children are vaccinated if indicated. During each SIS-C visit, age, gender, admission criteria and scheduled vaccinations were recorded, with any vaccine-related adverse events captured during SIS-PED visits. Follow-up was conducted to evaluate vaccination plan completion.Results359 children received 560 vaccine administrations (41.3% MMR/MMRV, 17.5% hexavalent) at the SIS during the 14 year study. Admission criteria were adverse events after previous vaccination (immediate, IgE/not IgE mediated, and late) in 27.2% of cases, non-anaphylactic allergies (mostly egg allergy) in 42.7% and anaphylaxis in 10.3%. After vaccination, 15/560 (2.7%) mild adverse events were observed. 96.3% of children vaccinated at least once at the SIS-PED and available for follow-up completed their vaccination plan, in contrast to 55.5% of children referred to the SIS-C who were not vaccinated in SIS-PED.ConclusionsFor children referred to SIS-C and available for follow-up, vaccination in SIS-PED was associated with more frequent completion of vaccination plans, indicating a benefit of the service to vaccine coverage. The low number and mild severity of adverse events reported after vaccination of high-risk children in SIS-PED attest to the safety of the service

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Section: Discussionsupporting

confidence: 90%

“…SIS in other settings have played a central role in improving adherence to regional vaccination plans and increasing immunization coverage [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Special Immunization Service: A 14-year experience in Italy

Donà¹,

Masiero²,

Brisotto³

et al. 2018

PLoS ONE

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“…The majority of cases (261/310, 84.2 %) had been referred from the community for suspected egg allergy. Only six patients (1.3 %) experienced an immediate reaction to the vaccine and all reactions were minor [ 81 ] (D).…”

Section: Allergic Reactions To Specific Vaccinesmentioning

confidence: 99%

International Consensus (ICON): allergic reactions to vaccines

Dreskin

Halsey

Kelso

et al. 2016

World Allergy Organization Journal

169

146

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BackgroundRoutine immunization, one of the most effective public health interventions, has effectively reduced death and morbidity due to a variety of infectious diseases. However, allergic reactions to vaccines occur very rarely and can be life threatening. Given the large numbers of vaccines administered worldwide, there is a need for an international consensus regarding the evaluation and management of allergic reactions to vaccines.MethodsFollowing a review of the literature, and with the active participation of representatives from the World Allergy Organization (WAO), the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma, and Immunology (AAAAI), and the American College of Allergy, Asthma, and Immunology (ACAAI), the final committee was formed with the purpose of having members who represented a wide-range of countries, had previously worked on vaccine safety, and included both allergist/immunologists as well as vaccinologists.ResultsConsensus was reached on a variety of topics, including: definition of immediate allergic reactions, including anaphylaxis, approaches to distinguish association from causality, approaches to patients with a history of an allergic reaction to a previous vaccine, and approaches to patients with a history of an allergic reaction to components of vaccines.ConclusionsThis document provides comprehensive and internationally accepted guidelines and access to on-line documents to help practitioners around the world identify allergic reactions following immunization. It also provides a framework for the evaluation and further management of patients who present either following an allergic reaction to a vaccine or with a history of allergy to a component of vaccines.

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“…This vaccine contains minimal amounts of egg proteins, from nanograms to picograms, often not precisely reported. Therefore, this vaccine shows a very low risk of allergic reactions, even in egg's anaphylaxis [9‐13] (Table 1). In Europe, prevalence of anaphylaxis due to MMR vaccine is estimated at 1.2 cases per million doses [14].…”

Section: Reviewmentioning

confidence: 99%

Vaccination in children with allergy to non active vaccine components

Franceschini

Bottau

Caimmi

et al. 2015

Clinical & Translational Med

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Childhood immunisation is one of the greatest public health successes of the last century. Vaccines contain an active component (the antigen) which induces the immune response. They may also contain additional components such as preservatives, additives, adjuvants and traces of other substances. This review provides information about risks of hypersensitivity reactions to components of vaccines. Furthermore, recommendations to avoid or reduce reactions to vaccine components have been detailed.

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A review of a paediatric emergency department vaccination programme for patients at risk of allergy/anaphylaxis

Cited by 20 publications

References 19 publications

Special Immunization Service: A 14-year experience in Italy

Special Immunization Service: A 14-year experience in Italy

International Consensus (ICON): allergic reactions to vaccines

Vaccination in children with allergy to non active vaccine components

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