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Some Children With Allergies At High Risk Of Measles Vaccine Side Effects
A DGReview of :"Measles vaccination for children with allergic diseases"
Japanese Journal of Allergy (Arerugi)
10/24/2002
By Elda Hauschildt
Some children with allergies should be considered high risk for side effects of measles vaccine.
Children undergoing food elimination therapy (besides egg) and those with specific immunoglobin E (IgE) greater than 3.5 UA/mL for egg white or greater than 0.35 UA/mL for cat dander should be included in this high-risk category, Japanese researchers say.
They suggest use of an intradermal skin test with 1:100 dilution to ascertain whether allergic children will react.
Seventy five children with allergies were tested using three types of skin tests: prick tests with undiluted vaccine, prick tests with 1:10 dilution and/or intradermal test with 1:100 dilution.
Children who tested negative on the skin tests received subcutaneous 0.5 mL doses of vaccine. Those who tested positive or positive/negative on at least one skin test were given subcutaneous vaccine in a divided method, using increments of 0.05 mL.
Investigators from Kanagawa Children's Medical Centre report the intradermal test with 1:100 dilution showed the highest sensitivity (88 percent) and relatively high specificity (75 percent) in predicting side effects.
A total of 49 children received normal vaccinations; 26 were treated using the divided method.
Children given vaccine by the divided method were more likely to be using elimination therapy for foods besides egg and to have significantly higher total IgE and specific IgE for egg white, cow's milk, wheat and cat dander.
Twenty five of the 26 children had specific IgE for egg white greater than 3.5 UA/mL; 8 of 11 showed specific IgE for cat dander greater than 0.35 UA/mL.
Side effects appeared in eight of the children. In seven, skin reaction was the only side effect. There were no cases of anaphylaxis.
Japanese Journal of Allergy (Arerugi), 2002; 51: 622-629.
"Measles vaccination for children with allergic diseases"
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