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OVERDIAGNOSIS OF VACCINE ALLERGY: SKIN TESTING AND CHALLENGE AT A PUBLIC SPECIALIZED UNIT (CRIE) IN RIO DE JANEIRO, BRAZIL
Brandão, Luciana Gomes Pedro et al. | Date Issued: 2023
Author
Brandão, Luciana Gomes Pedro
Tuyama, Mari
Carvalho, Flavio de
Santos, Ananza Taina da Silva
Lemos, Alberto dos Santos de
Costa, Marcellus Dias da
Mesquita, Emersom Cicilini
Cerbino-Neto, José
Varela, Margareth Catoia
Brasil, Pedro Emmanuel Alvarenga Americano do
Rondon, Angelica Varela
Affilliation
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil / Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil / D’Or Institute for Research and Education. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Health Surveillance and Immunization Research Unit. Rio de Janeiro, RJ, Brazil.
Oswaldo Cruz Foundation. National Institute of Infectious Disease Evandro Chagas. Reference Center for Special Immunobiologicals. Rio de Janeiro, RJ, Brazil.
Abstract
Background: Vaccination is an extremely safe public health intervention, but rare IgE-mediated adverse events must be identified to avoid the risk of anaphylaxis in the event of reexposure. However, using only clinical history to diagnose previous allergic reactions may lead to overdiagnosis of vaccine allergy and even to the use of medical exemptions as a subterfuge to mandatory vaccination. Methods: We conducted a retrospective study to describe the outcomes of patients with a history of vaccine or vaccine component allergy who were evaluated at our unit from 2011 to 2017. Data on allergy history, skin test results, vaccines prescribed, and adverse events were retrieved from the medical records at the Centro de Referencia para Imunobiologicos Especiais (Reference Center of Special immunobiologicals)–Fiocruz, in Rio de Janeiro, Brazil. Results: Of 34 adults with history of allergy to vaccine or vaccine components, 32 (94.1%) were successfully vaccinated without serious adverse events after our evaluation. In 12 patients (35%), the time elapsed between the allergy symptoms and evaluation in the Centro de Referencia para Imunobiologicos Especiais–Fiocruz was more than 10 years. Conclusion: Specialized care and use of skin tests allowed safe vaccination of the majority of patients. An objective, systematic evaluation of a history of vaccine allergy can prevent its improper use to avoid mandatory vaccination and reduce missed opportunities for immunization.
Keywords
Adults
Allergy
Vaccine
Immunization
Hypersensitivity
Skin allergic test
Prick test
Adverse event
 
Publisher
Elsevier
Citation
BRANDÃO, Luciana Gomes Pedro et al. Overdiagnosis of vaccine allergy: Skin testing and challenge at a public specialized unit (CRIE) in Rio de Janeiro, Brazil. Journal of Allergy and Clinical Immunology Global, v. 2, n. 3, p. 1-5, Aug. 2023.
DOI
10.1016/j.jacig.2023.100101
ISSN
2772-8293