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Measles, mumps, rubella vaccine administration in egg-sensitive children: systemic reactions during vaccine
A C Trotter1, B D Stone, D J Laszlo
1Department of Pediatrics, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC.
Insights
Egg-allergic children undergoing measles-mumps-rubella (MMR) vaccination may experience reactions. Skin testing and careful desensitization are recommended for allergic children receiving the MMR vaccine.
Area of Science:
- Pediatric Allergy and Immunology
- Vaccinology
- Clinical Immunology
Background:
- Egg-allergic children may face risks of acute allergic reactions to the measles-mumps-rubella (MMR) vaccine.
- Current guidelines suggest skin testing before MMR administration in egg-allergic children.
- Desensitization is recommended for those with positive skin tests to enable full vaccine dosage.
Purpose of the Study:
- To evaluate the safety and outcomes of measles-mumps-rubella (MMR) vaccine administration in egg-allergic children.
- To assess the incidence of hypersensitivity reactions during MMR desensitization in this cohort.
Main Methods:
- A retrospective review of 12 egg-allergic children (aged 12 months to 5 years) referred for MMR vaccination.
- Skin prick or intradermal testing with the commercial MMR vaccine was performed.
- Desensitization protocols were implemented for children with positive skin tests.
Main Results:
- Three out of 12 children exhibited positive skin tests to the MMR vaccine.
- Two of these three children experienced systemic hypersensitivity reactions during the desensitization process.
- All observed reactions occurred during the administration of undiluted vaccine doses.
Conclusions:
- Egg-allergic children should continue to undergo skin testing for MMR vaccine sensitivity.
- Close observation during desensitization is crucial for egg-allergic children with positive skin tests.
- The findings highlight potential risks associated with MMR desensitization in highly sensitive individuals.
Abstract:
In egg-sensitive children, measles-mumps-rubella (MMR) vaccination may cause acute allergic reactions; therefore, current recommendations are to perform skin testing with the commercial vaccine before administration to egg-allergic children. In children with positive skin tests, desensitization with the measles-mumps-rubella vaccine should be done in order to administer a full dose of the vaccine. Twelve egg-allergic children, aged 12 months to 5 years of age, were referred to our pediatric allergy clinic for MMR administration over a 20-month period. Three children had positive skin prick or intradermal tests to the MMR vaccine. Two of these three patients experienced systemic hypersensitivity reactions while undergoing desensitization to the MMR. All reactions occurred with injections of the undiluted vaccine. Based upon this experience, we recommend that egg-allergic children should continue to have cutaneous tests done to the MMR vaccine and careful observation during desensitization in those children with positive skin tests.