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A DGReview of :"Measles
vaccination for children with allergic diseases"
Japanese Journal of Allergy (Arerugi)
10/24/2002
By Elda Hauschildt
Some children with allergies should be considered high risk for side effects of
measles vaccine.
Children undergoing food elimination therapy (besides egg) and those with
specific immunoglobin E (IgE) greater than 3.5 UA/mL for egg white or greater
than 0.35 UA/mL for cat dander should be included in this high-risk category,
Japanese researchers say.
They suggest use of an intradermal skin test with 1:100 dilution to ascertain
whether allergic children will react.
Seventy five children with allergies were tested using three types of skin
tests: prick tests with undiluted vaccine, prick tests with 1:10 dilution and/or
intradermal test with 1:100 dilution.
Children who tested negative on the skin tests received subcutaneous 0.5 mL
doses of vaccine. Those who tested positive or positive/negative on at least one
skin test were given subcutaneous vaccine in a divided method, using increments
of 0.05 mL.
Investigators from Kanagawa Children's Medical Centre report the intradermal
test with 1:100 dilution showed the highest sensitivity (88 percent) and
relatively high specificity (75 percent) in predicting side effects.
A total of 49 children received normal vaccinations; 26 were treated using the
divided method.
Children given vaccine by the divided method were more likely to be using
elimination therapy for foods besides egg and to have significantly higher total
IgE and specific IgE for egg white, cow's milk, wheat and cat dander.
Twenty five of the 26 children had specific IgE for egg white greater than 3.5
UA/mL; 8 of 11 showed specific IgE for cat dander greater than 0.35 UA/mL.
Side effects appeared in eight of the children. In seven, skin reaction was the
only side effect. There were no cases of anaphylaxis.
Japanese Journal of Allergy (Arerugi), 2002; 51: 622-629.
"Measles vaccination for children with allergic diseases"
ALL INFORMATION, DATA, AND
MATERIAL CONTAINED, PRESENTED, OR PROVIDED HERE IS FOR GENERAL INFORMATION
PURPOSES ONLY AND IS NOT TO BE CONSTRUED AS REFLECTING THE KNOWLEDGE OR OPINIONS
OF THE PUBLISHER, AND IS NOT TO BE CONSTRUED OR INTENDED AS PROVIDING MEDICAL OR
LEGAL ADVICE. THE DECISION WHETHER OR NOT TO VACCINATE IS AN IMPORTANT AND
COMPLEX ISSUE AND SHOULD BE MADE BY YOU, AND YOU ALONE, IN CONSULTATION WITH
YOUR HEALTH CARE PROVIDER.