Allergic reactions after vaccination: translating guidelines into clinical practice

Eur Ann Allergy Clin Immunol. 2019 Mar;51(2):51-61. doi: 10.23822/EurAnnACI.1764-1489.86. Epub 2019 Jan 31.

Abstract

Vaccination represents one of the most powerful medical interventions on global health. Despite being safe, sustainable, and effective against infectious and in some cases also non-infectious diseases, it's nowadays facing general opinion's hesitancy because of a false perceived risk of adverse events. Adverse reactions to vaccines are relatively rare, instead, and those recognizing a hypersensitivity mechanism are even rarer. The purpose of this review is to offer a practical approach to adverse events after vaccination, focusing on immune-mediated reactions with particular regard to their recognition, diagnosis and management. According to clinical features, we propose an algorythm for allergologic work-up, which helps in confirming hypersensitivity to vaccine, nonetheless ensuring access to vaccination. Finally, a screening questionnaire is included, providing criteria for immunisation in specialized care settings.

Keywords: allergic reactions; anaphylaxis; desensitization; vaccination; vaccine; vaccine components; vaccine hesitancy.

Publication types

  • Review

MeSH terms

  • Anaphylaxis / diagnosis
  • Anaphylaxis / immunology*
  • Anaphylaxis / therapy*
  • Cold Temperature
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / immunology*
  • Drug Hypersensitivity / therapy*
  • Histamine Antagonists / therapeutic use
  • Humans
  • Practice Guidelines as Topic*
  • Vaccination / adverse effects
  • Vaccines / adverse effects*
  • Vaccines / immunology

Substances

  • Histamine Antagonists
  • Vaccines