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Related Experiment Videos

Adverse reactions to tetanus toxoid

R L Jacobs, R S Lowe, B Q Lanier

    JAMA
    |January 1, 1982
    PubMed
    Summary

    Patients with adverse reactions to tetanus toxoid immunization often report local swelling or anaphylaxis. Delayed hypersensitivity to mercury was noted in a few cases, but immediate skin tests were rarely reactive.

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    Area of Science:

    • Immunology
    • Allergy and Clinical Immunology
    • Vaccinology

    Background:

    • Adverse reactions to tetanus toxoid immunization can range from local symptoms to severe systemic responses.
    • Understanding the patterns and potential causes of these reactions is crucial for vaccine safety and patient management.

    Purpose of the Study:

    • To retrospectively analyze the types and frequencies of adverse reactions reported after tetanus toxoid immunization.
    • To investigate potential underlying causes, such as delayed hypersensitivity, and assess the utility of skin testing in patients with a history of adverse reactions.

    Main Methods:

    • Retrospective review of 740 patient charts with a documented history of adverse reactions to tetanus toxoid immunization.
    • Analysis of reported symptoms, immunization history, and results of immediate skin tests and challenge doses.

    Main Results:

    • The most frequently reported adverse reactions were local edema and tenderness (33%) and anaphylactoid responses (33%), followed by fever (15%).
    • Three patients exhibited vesicular eruptions, suggesting delayed hypersensitivity to mercury.
    • Immediate skin tests showed rare reactivity (<1%), and challenge doses were not associated with adverse events.

    Conclusions:

    • While local and anaphylactoid reactions are common after tetanus toxoid immunization, immediate skin testing appears to have limited predictive value for adverse events.
    • Delayed hypersensitivity to mercury may be an underrecognized cause of specific skin reactions in a subset of patients.

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