[Measles vaccination for children with allergic diseases]

To predict the side effects of vaccination, some skin tests are performed for patients with allergic diseases, though at present time there is no standard method. We have performed skin tests of measles vaccine by prick test with undiluted vaccine, 1 : 10 dilution, and/or intradermal test with 1 : 100 dilution. 75 cases of children with allergic diseases were assessed with more than two types of these skin tests. The cases with negative response for the skin tests were subcutaneously administered with 0.5ml of vaccine at once (normal method). On the other hand, the cases with positive or+/-response at least one skin test were subcutaneously administered with the vaccine in increments of 0.05ml (divided method). Including+/-response, intradermal test with 1 : 100 dilution showed highest sensitivity (88%) and relatively high specificity (75%) for the prediction of side effects in the 3 types of skin tests. Forty nine cases were vaccinated with the normal method, and 26 cases were vaccinated with the divided method. Compared with the cases with normal method, the cases with divided method showed higher frequency for patients with the elimination therapy of foods besides egg, and significantly higher value of total IgE, and specific IgE for egg white, cow's milk, wheat, and cat dander. Twenty five of 26 cases with the divided method showed specific IgE for egg white>3.5UA/ml, and 8 of 11 cases showed specific IgE for cat dander>0.35 UA/ml. In 8 cases who appeared side effects (one was administered by t he normal method, and 7 were administered by the divided method), 7 cases were local skin reaction only, and there were no cases of anaphylaxis. We recommend that the intradermal test of dilution 1: 100 should be performed to determine the vaccination method. The cases with the elimination therapy of foods besides egg, cases with specific IgE for egg white>3.5UA/ml, or cases with specific IgE for cat dander>0.35UA/ml, should be considered as high risk patients.