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Anaphylaxis from yellow fever vaccine.

J M Kelso¹, G T Mootrey, T F Tsai

¹Department of Internal Medicine (Allergy Division), Naval Medical Center, San Diego, Calif. 92134-5000, USA.

The Journal of Allergy and Clinical Immunology

|April 13, 1999

Summary

Yellow fever (YF) vaccine can cause anaphylactic reactions, estimated at about 1 in 131,000 doses. Pre-vaccination screening for allergies and preparedness for reactions are recommended.

Area of Science:

Immunology
Vaccinology
Public Health

Background:

Anaphylactic reactions to yellow fever (YF) vaccine are rarely reported in current literature.
Existing reports of YF vaccine-related anaphylaxis date back to the 1940s.

Purpose of the Study:

To estimate the incidence rate of anaphylaxis associated with the yellow fever vaccine.
To identify potential risk factors and allergens related to YF vaccine-induced anaphylaxis.

Main Methods:

Review of adverse event reports for YF vaccine submitted to the Vaccine Adverse Event Reporting System (VAERS) from 1990 to 1997.
Inclusion criteria focused on reports meeting definitions for probable or possible anaphylactic reactions.

Main Results:

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Out of 243 submitted reports, 40 met criteria for probable or possible anaphylaxis.

The estimated rate of YF vaccine-related anaphylaxis was approximately 1 in 131,000 doses (40 cases per 5,236,820 distributed doses).

Most reactions (34/35) occurred after the first dose, suggesting non-viral components like chicken embryo or gelatin may be allergens.

Conclusions:

Yellow fever vaccine administration is associated with a risk of anaphylactic reactions.
Pre-vaccination screening should include inquiries about prior adverse reactions to vaccines and allergies to eggs, chicken, or gelatin.
Healthcare providers must be prepared to recognize and manage YF vaccine-induced anaphylaxis.