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Evaluating children with suspected allergic reactions to vaccines for infectious diseases

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Vaccines often contain potentially allergenic material in addition to pathogen-specific immunogens that may induce allergic reactions. Parents and physicians often suspect that adverse reactions to vaccines are allergic in etiology. The concern that some of the substances contained in vaccines may trigger an anaphylactic reaction may lead to a low vaccination adherence with emergence of infectious disease epidemics.


To provide practical suggestions for managing children suspected to have an allergic reaction to a vaccine.


Information was obtained from a search of guidelines and relevant studies on allergic reactions to vaccines for infectious diseases.


True allergic reactions elicited by a vaccine are rare. Skin testing to the vaccine and to its components may identify the triggering agent. Graded dosing desensitization is helpful in children sensitized to the offending vaccine.


All children with a suspected allergic reaction to a vaccine should be carefully evaluated by routine allergy tests. When it is necessary, further immunization should be given under strict medical surveillance, which ensures that every child can safely complete the vaccination schedule.
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Keywords: Vaccine; allergy; anaphylaxis; children; egg; measles; vaccine antigens

Document Type: Research Article

Affiliations: 1: From the UOC Pediatria, Azienda Ospedaliero—Universitaria “Ospedali Riuniti,” Ancona, Italy 2: UOC Pediatria, Ospedale di Imola, Italy 3: Clinica Pediatrica—Fondazione IRCCS—Policlinico San Matteo, Pavia, Italy 4: UOC di Pediatria, Azienda Ospedaliera—Universitaria “Consorziale-Policlinico,” Ospedale Pediatrico Giovanni XXIII, Bari, Italy 5: UO Allergologia, Dipartimento di Pediatria, Università di Messina, Messina, Italy 6: UOC di Pediatria, Ospedale di Senigallia, Italy 7: UOC di Pediatria, Ospedale Città di Sesto San Giovanni, ASST Nord Milano, Sesto San Giovanni, Italy 8: Clinica Pediatrica, Università di Pisa, Pisa, Italy 9: UOC di Pediatria, Ospedale di Palmanova, AAS2 Bassa Friulana-Isontina, Palmanova, Italy 10: Clinica Pediatrica, Dipartimento di Medicina e Chirurgia, Università di Parma, Parma, Italy

Publication date: May 1, 2018

More about this publication?
  • Allergy and Asthma Proceedings is a peer reviewed publication dedicated to distributing timely scientific research regarding advancements in the knowledge and practice of allergy, asthma and immunology. Its primary readership consists of allergists and pulmonologists.

    The goal of the Proceedings is to publish articles with a predominantly clinical focus which directly impact quality of care for patients with allergic disease and asthma and by having the potential to directly impact the quality of patient care. AAP welcomes the submission of original works including peer-reviewed original research and clinical trial results. Additionally, as the official journal of the Eastern Allergy Conference (EAC), AAP will publish content from EAC poster sessions as well as review articles derived from EAC lectures.

    Featured topics include asthma, rhinitis, sinusitis, food allergies, allergic skin diseases, diagnostic techniques, allergens, and treatment modalities. Published material includes peer-reviewed original research, clinical trials and review articles.

    Articles marked "F" offer free full text for personal noncommercial use only.

    The journal is indexed in Thomson Reuters Web of Science and Science Citation Index Expanded, plus the National Library of Medicine's PubMed service.
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