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Allergic Diseases Vaccination of the Child

Year 2017, Volume: 9 Issue: 2, 178 - 185, 15.03.2017

Abstract

Abstract

Vaccines consist of an active component which induces the immune response andadditional non-active components such as preservatives, culture media antigens andadjuvants .The report of adverse events to vaccines increase with increased numbersof vaccinations .İmmunologic reactions to drugs classified into  two types as immediate and delayed; based upon the timing of the appearance of symptoms by The World Allergy Organization (WAO).This classification is intended to distinguish immunoglobulin E (IgE)-mediated reactions which account for many immediate type reactions and carry the risk of anaphylaxis, from other types of adverse events. Severe allergic reactions to vaccines are rare and difficult to predict . Therefore the vaccinator must carefully evaluate the child. Vaccines could be administered in the usualmanner in case of patients with contact dermatitis, and atopic dermatitis without foodallergy, however individuals with food allergy may need desensitization/graded doses of vaccine.  Administration of pneumococcal and influenza vaccine is recommended for children with asthma.

References

  • Kaynaklar 1.Thong B. Vervloet D. Drug Allergies. URL: http://www.worldal-lergy.org/professional/ allergic_diseases_center/drugallergy/.January, 20072.Kelso JM, Greenhawt MJ, Li JT, et al. Adverse reactions to vac-cines practice parameter 2012 update. J Allergy Clin Immunol2012;130:25-43. 3.Chung EH. Vaccine allergies. Clin Exp Vaccine Res. 2014Jan;3(1):50-7. 4.Bethesda, MD. National Asthma Education and PreventionProgram: Expert panel report III: Guidelines for the diagnosisand management of asthma.: National Heart, Lung, and BloodInstitute, 2007. 5.National Asthma Education and Prevention Program: Expert pa-nel report III: Guidelines for the diagnosis and management ofasthma. Bethesda, MD: National Heart, Lung, and Blood Insti-tute,2007.(NIHpublicationno.08-4051). www.nhlbi.nih.gov/gui-delines/asthma/asthgdln.htm (Accessed on December 04, 2014). 6.The safety of inactivated influenza vaccine in adults and child-ren with asthma. N Engl J Med 2001; 345:1529. 7.Cates CJ, Rowe BH. Vaccines for preventing influenza in peop-le with asthma. Cochrane Database Syst Rev 2013; 2:CD000364. 8.Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Kar-ron RA. Prevention and Control of Influenza with Vaccines: Re-commendations of the Advisory Committee on Immunization Prac-tices, United States, 2015-16 Influenza Season. MMWR Morb Mor-tal Wkly Rep. 2015;64(30):818. 9.Thompson MG, Clippard J, Petrie JG, Jackson ML, McLean HQ,Gaglani M, Reis EC, Flannery B, Monto AS, Jackson L, Belon-gia EA, Murthy K, Zimmerman RK, Thaker S, Fry AM. Influen-za Vaccine Effectiveness for Fully and Partially Vaccinated Child-ren 6 Months to 8 Years Old During 2011-2012 and 2012-2013:The Importance of Two Priming Doses. Pediatr Infect Dis J.2016;35(3):299. 10.Nuorti JP, Whitney CG, Centers for Disease Control and Pre-vention (CDC). Prevention of pneumococcal disease among in-fants and children - use of 13-valent pneumococcal conjugate vac-cine and 23-valent pneumococcal polysaccharide vaccine - re-commendations of the Advisory Committee on Immunization Prac-tices (ACIP). MMWR Recomm Rep 2010; 59:1. 11.Kasper WJ, Howe PM. Fatal varicella after a single course of cor-ticosteroids. Pediatr Infect Dis J. 1990 Oct;9(10):729-32. 12.Silk HJ, Guay-Woodford L, Perez-Atayde AR, Geha RS, Broff MD.Fatal varicella in steroid-dependent asthma. J Allergy Clin Im-munol. 1988 Jan;81(1):47-51. 13.Centers for Disease Control and Prevention. Varicella. In: Epide-miology and Prevention of Vaccine-Preventable Diseases. The PinkBook: Course Textbook, 13th ed, Hamborsky J, Kroger A, WolfeS, (Eds). Public Health Foundation, Washington, DC 2015.http://www.cdc.gov/vaccines/pubs/pinkbook/index.html 14.Verstraeten T, Jumaan AO, Mullooly JP, Seward JF, Izurieta HS,DeStefano F, Black SB, Chen RT; Vaccine Safety Datalink Re-search Group. A retrospective cohort study of the association ofvaricella vaccine failure with asthma, steroid use, age at vacci-nation, and measles-mumps-rubella vaccination. Pediatrics.2003 Aug;112(2):e98-103. 15.Centers for Disease Control and Prevention (CDC). Syncope af-ter vaccination--United States, January 2005-July 2007. MMWRMorb Mortal Wkly Rep. 2008 May 2;57(17):457-60. 16.Taylor SL, Hefler SL, Bindslev-Jensen C, Bock SA, Burks Jr AW,Christie L, et al.Factors affecting the determination of thresholddoses for allergenic foods:how much is too much? J Allergy ClinImmunol. 2002;109:24–30. 17.Erlewyn-Lajeunesse M, Hunt LP, Heath PT, Finn A. Anaphyla-xis as an adverse event following immunisation in the UK and Ire-land. Arch Dis Child.2012;97:487–90. 18.Andersen DV, Jørgensen IM. MMR vaccination of children withegg allergy is safe. Dan Med J. 2013;60:A4573. 19.James JM, Burks AW, Roberson PK, Sampson HA. Safe admi-nistration of the measles vaccine to children allergic to eggs. NEngl J Med. 1995;332(19):1262. 20.Sakaguchi M, Ogura H, Inouye S. IgE antibody to gelatin in child-ren with immediate-type reactions to measles and mumps vacci-nes. J Allergy Clin Immunol. 1995 Oct;96(4):563-5. 21.Sakaguchi M, Inouye S Systemic allergic reactions to gelatin in-cluded in vaccines as a stabilizer. Jpn J Infect Dis. 2000Oct;53(5):189-95. 22.Kelso JM. Potential food allergens in medications. J Allergy ClinImmunol.2014;133:1509–18. 23.Li JT, Rank MA, Squillace DL, Kita H. Ovalbumin content of in-fluenza vaccines. J Allergy Clin Immunol. 2010;125:1412–3. 24.Des Roches A, Paradis L, Gagnon R, Lemire C, Begin P, CarrS, et al. Egg-allergic patients can be safely vaccinated againstinfluenza. J Allergy Clin Immunol. 2012;130:1213–5. 25.Kattan JD, Konstantinou GN, Cox AL, et al. Anaphylaxis to dipht-heria, tetanus, and pertussis vaccines among children with cow'smilk allergy. J Allergy Clin Immunol 2011; 128:215. 26.DiMiceli L, Pool V, Kelso JM, Shadomy SV, Iskander J, VAERSTeam. Vaccination of yeast sensitive individuals: review of sa-fety data in the US vaccine adverse event reporting system (VA-ERS). Vaccine. 2006;24:703–7.27.Kelso JM. Potential food allergens in medications. J Allergy ClinImmunol.2014;133:1509–18. 28.Herman JJ, Radin R, Schneiderman R. Allergic reactions to me-asles (rubeola) vaccine in patients hypersensitive to egg prote-ins. J Pediatr. 1983;102:196–199 29.Kelso JM, Jones RT, Yunginger JW. Anaphylaxis to measles,mumps, and rubella vaccine mediated by IgE to gelatin. J AllergyClin Immunol. 1993;91:867–872 30.Sakaguchi M, Nakayama T, Inouye S. Food allergy to gelatin inchildren with systemic immediate-type reactions, includinganaphylaxis, to vaccines.J Allergy Clin Immunol.1996;98:1058–1061 31.Bogdanovic J, Halsey NA, Wood RA, Hamilton RG. Bovine andporcine gelatin sensitivity in children sensitized to milk and meat.J Allergy Clin Immunol. 2009;124:1108–10. 32.Mullins RJ, James H, Platts-Mills TA, Commins S. Relationshipbetween red meat allergy and sensitization to gelatin and galac-tose-α-1,3-galactose. J Allergy Clin Immunol. 2012;129:1334–42. 33.Giordano-Labadie F, Rance F, Pellegrin F, et al.: Frequencyof contact allergy in children with atopic dermatitis: results ofa prospective study of 137 cases. Contact Dermatitis 1999,40:192–195. 34.Wollenberg A, Vogel S, Renner ED. Vaccinations with atopic der-matitis and other chronic inflammatory skin diseases. Hautarzt.2010 Nov;61(11):985-93 35.Gruber C, Warner J, Hill D et al (2008) Early atopic disease andearly child-hood immunization – is there a link? Allergy63:1464–1472. 36.P, Stephenson TJ: Systemic exposure, tolerability and effi cacyof pimecrolimus cream 1% in atopic dermatitis patients. Arch DisChild 2003; 88: 969–973.37. 37.. Papp KA, Breuer K, Meurer M, Ortonne JP, Potter PC, deProst Y, Davidson MJ, Barbier N, Goertz HP, Paul C: Long-termtreatment of atopic dermatitis with pimecrolimus cream 1% ininfants does not interfere with the development of protective an-tibodies after vaccination J Am Acad Dermatol 2005; 52:247–253. 38.Stiehm ER, Roberts RL, Kaplan MS, Corren J: Tacrolimus oint-ment does not alter immune responses of eczematous children.J Allergy Clin Immunol 2003; 111:S355. 39.Wollenberg A, Oranje A, Deleuran M, Simon D, Szalai Z, KunzB, Svensson A, Barbarot S, von Kobyletzki L, Taieb A, de Bru-in-Weller M, Werfel T, Trzeciak M, Vestergard C, Ring J, Dar-sow U; European Task Force on Atopic Dermatitis/EADV Ec-zema Task Force.ETFAD/EADV Eczema task force 2015 posi-tion paper on diagnosis and treatment of atopic dermatitis in adultand paediatric patients. J Eur Acad Dermatol Venereol. 2016May;30(5):729-47. 40.Goyal A, Goyal K, Merola JF. Screening and vaccinations in pa-tients requiring systemic immunosuppression: an update for der-matologists. Am J Clin Dermatol. 2015 Jun;16(3):179-95. 41.Russel M, Pool V, Kelso JM, Tomazic-Jezic VJ. Vaccination ofpersons allergic to latex: a review of safety data in the VaccineAdverse Event Reporting Sistem (VAERS). Vaccine.2004;23:664–6. 42.Lear JT, English JS. Anaphylaxis after hepatitis B vaccination.Lancet 1995;345:1249.43.Offit P, Jew R. Addressing parents' concerns: do vaccines con-tain harmful preservatives, adjuvants, additives, or residuals? Pe-diatrics 2003;112(6 Pt 1):1394-7 44.Hem SL. Elimination of aluminum adjuvants. Vaccine 2002;20:S40-3. 45.King K, Paterson M, Green SK. Global justice and the proposedban on thimerosal containing vaccines. Pediatrics.2013;131:154–6. 46.Cox NH, Forsyth A. Thimerosal allergy and vaccination reacti-ons. Contact Dermatitis 1988;18:229-33. 47.Fitzgerald KA, Davies A, Russell AD. Mechanism of action of chlor-hexidine diacetate and phenoxyethanol singly and in combinati-on against gram-negative bacteria. Microbios 1992;70: 215-3 48.Georgitis JW, Fasano MB. Allergenic components of vaccines andavoidance of vaccination-related adverse events. Curr Allergy Rep.2001 Jan;1(1):11-7. 49.McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS; Centers forDisease Control and Prevention. Prevention of measles, rubella,congenital rubella syndrome, and mumps, 2013: summary recom-mendations of the Advisory Committee on Immunization Practi-ces (ACIP). MMWR Recomm Rep. 2013 Jun 14;62(RR-04):1-34.

Alerjik Hastalıklakları Olan Çocuğun Aşılanması

Year 2017, Volume: 9 Issue: 2, 178 - 185, 15.03.2017

Abstract

Öz

Aşı içeriği immun yanıtı oluşturan aktif antijenik içeriği ile koruyucular, kültürantijenleri ve adjuvanlardan oluşan  aktif olmayan  bileşenlerden oluşur. Aşılamanın giderek artması ile yan etki bildirimleri de artmaktadır. Dünya Alerji Topluluğu (The World Allergy Organization-WAO) ilaçlara karşı gelişen immunolojik reaksiyonları semptomların başlangıç zamanına göre erken ve gecikmiş tip olarak sınıflamıştır . Bu sınıflamanın amacı erken tipte reaksiyonların büyük çoğunluğunu oluşturan ve anaflaksi riski taşıyan immunglobulin E (IgE) aracılı reaksiyonları diğer yanetkilerden ayırt etmektir. Aşıya karşı ciddi alerjik yanıt nadir görülür ve önceden tahmini güçtür. Bu nedenle aşıyı yapacak kişi hastayı dikkatle değerlendirmelidir. Besin alerjisi olan kişilerde desensitizasyona, bölünmüş dozlarda uygulamaya ihtiyaç duyulabilirken, kontakt dermatiti vaya besin alerjisi olmayan atopik egzeması  olan hastalarda aşılar standart biçimde uygulanır. Astım hastalarında ise pnömokok ve influenza virüs infeksiyonlarına karşı aşılama önerilir.

References

  • Kaynaklar 1.Thong B. Vervloet D. Drug Allergies. URL: http://www.worldal-lergy.org/professional/ allergic_diseases_center/drugallergy/.January, 20072.Kelso JM, Greenhawt MJ, Li JT, et al. Adverse reactions to vac-cines practice parameter 2012 update. J Allergy Clin Immunol2012;130:25-43. 3.Chung EH. Vaccine allergies. Clin Exp Vaccine Res. 2014Jan;3(1):50-7. 4.Bethesda, MD. National Asthma Education and PreventionProgram: Expert panel report III: Guidelines for the diagnosisand management of asthma.: National Heart, Lung, and BloodInstitute, 2007. 5.National Asthma Education and Prevention Program: Expert pa-nel report III: Guidelines for the diagnosis and management ofasthma. Bethesda, MD: National Heart, Lung, and Blood Insti-tute,2007.(NIHpublicationno.08-4051). www.nhlbi.nih.gov/gui-delines/asthma/asthgdln.htm (Accessed on December 04, 2014). 6.The safety of inactivated influenza vaccine in adults and child-ren with asthma. N Engl J Med 2001; 345:1529. 7.Cates CJ, Rowe BH. Vaccines for preventing influenza in peop-le with asthma. Cochrane Database Syst Rev 2013; 2:CD000364. 8.Grohskopf LA, Sokolow LZ, Olsen SJ, Bresee JS, Broder KR, Kar-ron RA. Prevention and Control of Influenza with Vaccines: Re-commendations of the Advisory Committee on Immunization Prac-tices, United States, 2015-16 Influenza Season. MMWR Morb Mor-tal Wkly Rep. 2015;64(30):818. 9.Thompson MG, Clippard J, Petrie JG, Jackson ML, McLean HQ,Gaglani M, Reis EC, Flannery B, Monto AS, Jackson L, Belon-gia EA, Murthy K, Zimmerman RK, Thaker S, Fry AM. Influen-za Vaccine Effectiveness for Fully and Partially Vaccinated Child-ren 6 Months to 8 Years Old During 2011-2012 and 2012-2013:The Importance of Two Priming Doses. Pediatr Infect Dis J.2016;35(3):299. 10.Nuorti JP, Whitney CG, Centers for Disease Control and Pre-vention (CDC). Prevention of pneumococcal disease among in-fants and children - use of 13-valent pneumococcal conjugate vac-cine and 23-valent pneumococcal polysaccharide vaccine - re-commendations of the Advisory Committee on Immunization Prac-tices (ACIP). MMWR Recomm Rep 2010; 59:1. 11.Kasper WJ, Howe PM. Fatal varicella after a single course of cor-ticosteroids. Pediatr Infect Dis J. 1990 Oct;9(10):729-32. 12.Silk HJ, Guay-Woodford L, Perez-Atayde AR, Geha RS, Broff MD.Fatal varicella in steroid-dependent asthma. J Allergy Clin Im-munol. 1988 Jan;81(1):47-51. 13.Centers for Disease Control and Prevention. Varicella. In: Epide-miology and Prevention of Vaccine-Preventable Diseases. The PinkBook: Course Textbook, 13th ed, Hamborsky J, Kroger A, WolfeS, (Eds). Public Health Foundation, Washington, DC 2015.http://www.cdc.gov/vaccines/pubs/pinkbook/index.html 14.Verstraeten T, Jumaan AO, Mullooly JP, Seward JF, Izurieta HS,DeStefano F, Black SB, Chen RT; Vaccine Safety Datalink Re-search Group. A retrospective cohort study of the association ofvaricella vaccine failure with asthma, steroid use, age at vacci-nation, and measles-mumps-rubella vaccination. Pediatrics.2003 Aug;112(2):e98-103. 15.Centers for Disease Control and Prevention (CDC). Syncope af-ter vaccination--United States, January 2005-July 2007. MMWRMorb Mortal Wkly Rep. 2008 May 2;57(17):457-60. 16.Taylor SL, Hefler SL, Bindslev-Jensen C, Bock SA, Burks Jr AW,Christie L, et al.Factors affecting the determination of thresholddoses for allergenic foods:how much is too much? J Allergy ClinImmunol. 2002;109:24–30. 17.Erlewyn-Lajeunesse M, Hunt LP, Heath PT, Finn A. Anaphyla-xis as an adverse event following immunisation in the UK and Ire-land. Arch Dis Child.2012;97:487–90. 18.Andersen DV, Jørgensen IM. MMR vaccination of children withegg allergy is safe. Dan Med J. 2013;60:A4573. 19.James JM, Burks AW, Roberson PK, Sampson HA. Safe admi-nistration of the measles vaccine to children allergic to eggs. NEngl J Med. 1995;332(19):1262. 20.Sakaguchi M, Ogura H, Inouye S. IgE antibody to gelatin in child-ren with immediate-type reactions to measles and mumps vacci-nes. J Allergy Clin Immunol. 1995 Oct;96(4):563-5. 21.Sakaguchi M, Inouye S Systemic allergic reactions to gelatin in-cluded in vaccines as a stabilizer. Jpn J Infect Dis. 2000Oct;53(5):189-95. 22.Kelso JM. Potential food allergens in medications. J Allergy ClinImmunol.2014;133:1509–18. 23.Li JT, Rank MA, Squillace DL, Kita H. Ovalbumin content of in-fluenza vaccines. J Allergy Clin Immunol. 2010;125:1412–3. 24.Des Roches A, Paradis L, Gagnon R, Lemire C, Begin P, CarrS, et al. Egg-allergic patients can be safely vaccinated againstinfluenza. J Allergy Clin Immunol. 2012;130:1213–5. 25.Kattan JD, Konstantinou GN, Cox AL, et al. Anaphylaxis to dipht-heria, tetanus, and pertussis vaccines among children with cow'smilk allergy. J Allergy Clin Immunol 2011; 128:215. 26.DiMiceli L, Pool V, Kelso JM, Shadomy SV, Iskander J, VAERSTeam. Vaccination of yeast sensitive individuals: review of sa-fety data in the US vaccine adverse event reporting system (VA-ERS). Vaccine. 2006;24:703–7.27.Kelso JM. Potential food allergens in medications. J Allergy ClinImmunol.2014;133:1509–18. 28.Herman JJ, Radin R, Schneiderman R. Allergic reactions to me-asles (rubeola) vaccine in patients hypersensitive to egg prote-ins. J Pediatr. 1983;102:196–199 29.Kelso JM, Jones RT, Yunginger JW. Anaphylaxis to measles,mumps, and rubella vaccine mediated by IgE to gelatin. J AllergyClin Immunol. 1993;91:867–872 30.Sakaguchi M, Nakayama T, Inouye S. Food allergy to gelatin inchildren with systemic immediate-type reactions, includinganaphylaxis, to vaccines.J Allergy Clin Immunol.1996;98:1058–1061 31.Bogdanovic J, Halsey NA, Wood RA, Hamilton RG. Bovine andporcine gelatin sensitivity in children sensitized to milk and meat.J Allergy Clin Immunol. 2009;124:1108–10. 32.Mullins RJ, James H, Platts-Mills TA, Commins S. Relationshipbetween red meat allergy and sensitization to gelatin and galac-tose-α-1,3-galactose. J Allergy Clin Immunol. 2012;129:1334–42. 33.Giordano-Labadie F, Rance F, Pellegrin F, et al.: Frequencyof contact allergy in children with atopic dermatitis: results ofa prospective study of 137 cases. Contact Dermatitis 1999,40:192–195. 34.Wollenberg A, Vogel S, Renner ED. Vaccinations with atopic der-matitis and other chronic inflammatory skin diseases. Hautarzt.2010 Nov;61(11):985-93 35.Gruber C, Warner J, Hill D et al (2008) Early atopic disease andearly child-hood immunization – is there a link? Allergy63:1464–1472. 36.P, Stephenson TJ: Systemic exposure, tolerability and effi cacyof pimecrolimus cream 1% in atopic dermatitis patients. Arch DisChild 2003; 88: 969–973.37. 37.. Papp KA, Breuer K, Meurer M, Ortonne JP, Potter PC, deProst Y, Davidson MJ, Barbier N, Goertz HP, Paul C: Long-termtreatment of atopic dermatitis with pimecrolimus cream 1% ininfants does not interfere with the development of protective an-tibodies after vaccination J Am Acad Dermatol 2005; 52:247–253. 38.Stiehm ER, Roberts RL, Kaplan MS, Corren J: Tacrolimus oint-ment does not alter immune responses of eczematous children.J Allergy Clin Immunol 2003; 111:S355. 39.Wollenberg A, Oranje A, Deleuran M, Simon D, Szalai Z, KunzB, Svensson A, Barbarot S, von Kobyletzki L, Taieb A, de Bru-in-Weller M, Werfel T, Trzeciak M, Vestergard C, Ring J, Dar-sow U; European Task Force on Atopic Dermatitis/EADV Ec-zema Task Force.ETFAD/EADV Eczema task force 2015 posi-tion paper on diagnosis and treatment of atopic dermatitis in adultand paediatric patients. J Eur Acad Dermatol Venereol. 2016May;30(5):729-47. 40.Goyal A, Goyal K, Merola JF. Screening and vaccinations in pa-tients requiring systemic immunosuppression: an update for der-matologists. Am J Clin Dermatol. 2015 Jun;16(3):179-95. 41.Russel M, Pool V, Kelso JM, Tomazic-Jezic VJ. Vaccination ofpersons allergic to latex: a review of safety data in the VaccineAdverse Event Reporting Sistem (VAERS). Vaccine.2004;23:664–6. 42.Lear JT, English JS. Anaphylaxis after hepatitis B vaccination.Lancet 1995;345:1249.43.Offit P, Jew R. Addressing parents' concerns: do vaccines con-tain harmful preservatives, adjuvants, additives, or residuals? Pe-diatrics 2003;112(6 Pt 1):1394-7 44.Hem SL. Elimination of aluminum adjuvants. Vaccine 2002;20:S40-3. 45.King K, Paterson M, Green SK. Global justice and the proposedban on thimerosal containing vaccines. Pediatrics.2013;131:154–6. 46.Cox NH, Forsyth A. Thimerosal allergy and vaccination reacti-ons. Contact Dermatitis 1988;18:229-33. 47.Fitzgerald KA, Davies A, Russell AD. Mechanism of action of chlor-hexidine diacetate and phenoxyethanol singly and in combinati-on against gram-negative bacteria. Microbios 1992;70: 215-3 48.Georgitis JW, Fasano MB. Allergenic components of vaccines andavoidance of vaccination-related adverse events. Curr Allergy Rep.2001 Jan;1(1):11-7. 49.McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS; Centers forDisease Control and Prevention. Prevention of measles, rubella,congenital rubella syndrome, and mumps, 2013: summary recom-mendations of the Advisory Committee on Immunization Practi-ces (ACIP). MMWR Recomm Rep. 2013 Jun 14;62(RR-04):1-34.
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Primary Language Turkish
Journal Section makale
Authors

Prof. Dr. Emin Özkaya This is me

Publication Date March 15, 2017
Published in Issue Year 2017 Volume: 9 Issue: 2

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APA Özkaya, P. D. E. (2017). Alerjik Hastalıklakları Olan Çocuğun Aşılanması. Klinik Tıp Pediatri Dergisi, 9(2), 178-185.
AMA Özkaya PDE. Alerjik Hastalıklakları Olan Çocuğun Aşılanması. Pediatri. March 2017;9(2):178-185.
Chicago Özkaya, Prof. Dr. Emin. “Alerjik Hastalıklakları Olan Çocuğun Aşılanması”. Klinik Tıp Pediatri Dergisi 9, no. 2 (March 2017): 178-85.
EndNote Özkaya PDE (March 1, 2017) Alerjik Hastalıklakları Olan Çocuğun Aşılanması. Klinik Tıp Pediatri Dergisi 9 2 178–185.
IEEE P. D. E. Özkaya, “Alerjik Hastalıklakları Olan Çocuğun Aşılanması”, Pediatri, vol. 9, no. 2, pp. 178–185, 2017.
ISNAD Özkaya, Prof. Dr. Emin. “Alerjik Hastalıklakları Olan Çocuğun Aşılanması”. Klinik Tıp Pediatri Dergisi 9/2 (March 2017), 178-185.
JAMA Özkaya PDE. Alerjik Hastalıklakları Olan Çocuğun Aşılanması. Pediatri. 2017;9:178–185.
MLA Özkaya, Prof. Dr. Emin. “Alerjik Hastalıklakları Olan Çocuğun Aşılanması”. Klinik Tıp Pediatri Dergisi, vol. 9, no. 2, 2017, pp. 178-85.
Vancouver Özkaya PDE. Alerjik Hastalıklakları Olan Çocuğun Aşılanması. Pediatri. 2017;9(2):178-85.