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Measles immunisation in children with allergy to egg

Department of Allergy, Royal Children's Hospital, Melbourne, Australia Correspondence to: Dr A S Kemp, Department of Clinical Immunology, Royal Children's Hospital, Flemington Road, Parkville, Victoria 3052, Australia.

Abstract

Objective : To examine the occurrence of adverse reactions to measles vaccine given as a single dose to children with egg allergy, and to determine if the administration of single dose to children with a positive result in an intradermal skin prick test with the vaccine is associated with adverse reactions.
Design : Review of results of immunisation and prospective study of 96 consecutively presenting children given intradermal skin testing with the vaccine.
Setting : Children's allergy centre.
Subjects : 410 children sensitive to egg referred to the allergy unit for advice about measles immunisation.
Main outcome measures : Nature and severity of reactions associated with the administration of measles vaccine.
Results : All children had a positive result in a skin prick test with egg white, and five had a positive result in a skin prick test with vaccine. Of 96 consecutive children, 46 had a positive result in an intradermal test with vaccine. After immunisation with a full dose (0.5 ml) of vaccine adverse reactions were associated with a mild reaction in four children, none of whom required treatment. Only one of the 46 children with a positive result in an intradermal vaccine skin test had a reaction associated with vaccine administration. None of the children with a positive result in a skin prick test with measles vaccine reacted to the vaccine. The rate of minor reactions to the vaccine not requiring treatment was 0.98% (95% confidence interval 0.27% to 2.48%) and serious reactions requiring treatment was 0% (0% to 0.9%).
Conclusion : Children with IgE mediated allergic reactions to egg protein should be investigated and managed by practitioners with special knowledge in this subject. Measles immunisation should be performed in a setting where any adverse reactions can be dealt with appropriately. Skin tests and measles vaccine and desensitisation are not necessary.

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Adverse reactions to measles immunisation

C Caffarelli, G Cavagni, F M Deriu, and G F Zambelloni
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