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[Desensitization to diphtheria, tetanus and pertussis vaccine]
Marina Atanasković-Marković1, Branimir Nestorović
1University Children's Hospital, Belgrade. marinaa@eunet.yu
Insights
Children with suspected DTP vaccine allergy can be safely immunized. Premedication with antihistamines before desensitization significantly reduced allergic reactions, allowing vaccination to proceed.
Area of Science:
- Pediatric Allergy and Immunology
- Vaccinology
- Immunology
Context:
- Childhood immunization schedules commonly include DTP vaccine (diphtheria, tetanus, and pertussis).
- Adverse allergic reactions to DTP vaccine range from mild to life-threatening anaphylaxis.
- Vaccination interruption due to allergic reactions necessitates careful management for continued immunization.
Purpose:
- To evaluate the safety and efficacy of desensitization protocols for children with suspected anaphylactic reactions to DTP and related vaccines.
- To assess the impact of antihistamine premedication on allergic reactions during DTP vaccine desensitization.
Summary:
- A study of 137 children with suspected DTP vaccine allergy utilized skin tests and desensitization protocols.
- Children with negative skin tests received a single vaccine dose.
- For positive tests, desensitization was performed; one group received antihistamine premedication.
- Premedication resulted in only minor local reactions in 3.8% of children, with no systemic reactions observed post-desensitization.
Impact:
- Demonstrates that children with prior allergic reactions to DTP vaccine can be safely re-immunized using desensitization protocols.
- Highlights the benefit of antihistamine premedication in minimizing allergic responses during DTP vaccine desensitization.
- Supports the continuation of essential childhood immunizations in children with a history of vaccine allergy.
Abstract:
Immunization with DTP vaccine (diphtheria, tetanus and pertussis) is a part of the vaccination calendar offered in childhood. Adverse allergic reactions vary from minimal urticarial reactions to life-threatening anaphylaxis. In infancy these reactions usually interrupt the vaccination calendar, but immunization in these children should be done. At the University Children's Hospital of Belgrade, a group of 137 children with suspected allergic anaphylactic reaction to DTP, DT, TT and monopertussis vaccine was studied for the last six years. Skin (prick and intradermal) tests were performed with corresponding vaccine. If both tests were negative, the vaccine could be given as a single dose of 0.5 ml. If one of these tests were positive desensitization with vaccine could be done (according to the protocol described by Carey and Meltzer). In one group of 52 children three days before desensitization, premedication with antihistamines, was done, whereas in the other group of 52 children premedication was not done. Two (3.8%) children in a group of 52 children with premedication had a minor (local) reaction after vaccination and 50 children (96.2%) had no reaction after vaccination, whereas no children (0%) had systemic reaction after desensitization.
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