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Safe immunization of allergic children against measles, mumps, and rubella
Insights
Children with common allergies can safely receive the measles, mumps, and rubella (MMR) vaccine. Pre-vaccination allergy testing showed high rates of negative reactions, indicating safety for most allergic individuals.
Area of Science:
- Immunology
- Pediatrics
- Allergy
Background:
- Systemic allergies are common in children.
- Concerns exist regarding the safety of vaccinations, such as the measles, mumps, and rubella (MMR) vaccine, in allergic individuals.
- Previous adverse reactions to other vaccines warrant careful consideration for MMR vaccination.
Purpose of the Study:
- To assess the safety and efficacy of MMR vaccination in children with documented or suspected systemic allergies.
- To determine the utility of pre-vaccination skin prick testing for MMR vaccine in allergic populations.
- To evaluate the risk of adverse reactions following MMR vaccination in children with a history of atopic eczema, asthma, or cow's-milk allergy.
Main Methods:
- A cohort of 135 subjects (134 children, 1 adult) with allergies underwent MMR skin prick testing.
- Subjects included those with atopic eczema, asthma, cow's-milk allergy, and a history of severe reactions to other vaccines.
- Vaccination status and any adverse reactions post-MMR administration were recorded.
Main Results:
- The undiluted MMR skin prick test yielded negative reactions in 93% of subjects.
- Non-reactivity rates were high across allergic subgroups: 96% in atopic eczema, 91% in asthma, and 82% in cow's-milk allergy.
- Of 129 eligible subjects, 95% received the MMR vaccine without significant adverse events, with only two experiencing mild urticaria or fever.
Conclusions:
- The measles, mumps, and rubella (MMR) vaccine is safe for at least 95% of children with common systemic allergies.
- Allergic diseases, including atopic eczema and asthma, should not be a contraindication for routine MMR vaccination.
- Pre-vaccination allergy testing may not be necessary for all children prior to MMR vaccination, simplifying vaccination programs.
Abstract:
A series of 135 subjects (134 children and one adult) with documented or suspected systemic allergy were prick-tested before a measles, mumps, and rubella (MMR) vaccination. Atopic eczema was documented in 68, asthma in 47, and cow's-milk allergy in 11 examinees; eight children were evaluated because of severe systemic reactions following diphtheria-pertussis-tetanus, measles, or inactivated polio (Salk) vaccinations. In one child, there was only a suspicion of general allergy. The undiluted MMR prick test gave negative reactions in 126 cases (93%). The highest rate of nonreactivity was observed in those with atopic eczema (96%) and in children with asthma (91%) or cow's-milk allergy (82%). All examinees with systemic reactions after other vaccinations also had negative prick-test reactions. A total of 122 (95%) of the 129 examinees were eventually vaccinated with MMR. No untoward reactions developed, except mild generalized urticaria or fever in two vaccinees. We conclude that at least 95% of children with common forms of systemic allergy can be vaccinated safely with MMR and, in general, that allergic diseases should not interfere with execution of the vaccination programs.