Öz
Abstract
The administration of the MMR (measles-mumps-rubella) vaccine, which is routinely in the vaccine program in our country, creates unnecessary anxiety due to allergic reactions in children with egg allergy by the families and healthcare personnel. These patients are directed to allergy clinics for MMR vaccination. In addition,patients who develop allergic reaction after previous vaccination are also referredto allergy clinics for diagnostic tests (specific immunoglobulin E (spiGE), skin pricktest and intradermal test). In the Ministry of Health 2008 'Extended ImmunizationProgram Circular', anaphylaxis with gelatin and neomycin, egg anaphylaxis, or anaphylactoid reaction is reported as a definite contraindication for the MMR vaccine while the reactions other than anaphlaxy is not contrandication. In the Red Book, it is reported that the risk for anaphylactic reaction is low in patients with egg allergy (evenif there is a serious hypersensitivity history) because thereactions are related to the vaccine components such asgelatin. However, it was noted that patients who developed an allergic reaction to previous vaccination should be evaluated by an allergist for future dosing.
Anahtar Kelimeler
Egg Allergy Measles RubellaMumps Vaccine Skin PrickTest İntradermal Test
Kaynakça
- Kaynaklar 1.Sicherer SH, Sampson HA.Food allergy: A review and upda-te on epidemiology, pathogenesis, diagnosis, prevention, andmanagement.J Allergy Clin Immunol. 2018 Jan;141(1):41-58. 2.EAACI Food Allergy and Anaphylaxis Guidelines Group.Al-lergy. 2014 Aug;69(8):1008-25. doi: 10.1111/all.12429.Epub 2014 Jun 9. 3.Ovomucoid specific immunoglobulin E as a predictor of to-lerance to cooked egg. Lisa M. Bartnikas, M.D.1,2 WilliamJ. Sheehan, M.D.,1,2 Katherine L. Tuttle, M.D.,2,3 Carter R.Petty, M.A.,4 Lynda C. Schneider, M.D.,1,2 and Wanda Phi-patanakul, M.D., M.S.1, Sicherer SH, Sampson HA. Food al-lergy. J Allergy Clin Immunol 2006; 117(2 Suppl Mini-Pri-mer): S470. 4.Cerecedo Carballo I, Dieguez Pastor MC, Bartolomé Zava-la B, et al. Safety of measles-mumps-rubella vaccine (MMR)in patients allergic to eggs. Allergol et Immunopathol 2007;35(3):105-9. 5.McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS, Centersfor Disease Control and Prevention. Prevention of measles,rubella, congenital rubella syndrome, and mumps, 2013: sum-mary recommendations of the Advisory Committee on Immu-nization Practices (ACIP). MMWR Recomm Rep 2013;62(RR-04):1. 6.Chow WC, Eyw K, Lau YL. Measles-mumps-rubella vaccina-tion and egg allergy. HKJ Pediatr 2003;8:35-39 7.Dreskin SC, Halsey NA, Kelso JM, et al. International Con-sensus (ICON): allergic reactions to vaccines. World AllergyOrganization Journal 2016;9:32. 8.Elliman D, Dhanraj B. Safe MMR vaccination despite neomycinallergy. Lancet. 1991;337:365. 9.Kwittken PL, Rosen S, Sweinberg SK. MMR vaccine and neo-mycin allergy. Am J Dis Child. 1993;147:128–9. 10.Van Asperen PP, McEnlery J, Kemp AS. Immediate reactionsfollowing live attenuated measles vaccine. Med J Aust.1981;2:330–1. 11.McEwan J. Early-onset reaction after measles vaccination –Further Australian reports. Med J Aust. 1983;2:503–5. 12.Kemp A, Van Asperen P, Mukhi A. Measles immunization inchildren with clinical reactions to egg protein. Am J Dis Child.1990;144:33–5. 13.Nakayama T, Aizawa C, Kuno-Sakai H. A clinical analysis ofgelatin allergy and determination of its causal relationship tothe previous administration of gelatin-containing acellular per-tussis vaccine combined with diphtheria and tetanus toxoids.J Allergy Clin Immunol 1999; 103: 321-5. 14.Czajka H, Schuster V, Zepp F, Esposito S, Douha M, WillemsP. A combined measles, mumps, rubella and varicella vacci-ne (PriorixTetra): Immunogenicity and safety profile. Vacci-ne 2009; 27: 6504-11. 15.MMR and MMR vaccines Kowalzik F, Faber J, Knuf M.Vac-cine. 2017 Jul 27. pii: S0264-410X(17)30959-3. 16.Baxter DN. Measles immünization in children with a historyof egg allergy. Vaccine 1996;14:131-134 17.Aickin R, Hill D, Kemp A. Measles immunisation in childrenwith allergy to egg. BMJ 1994;309(6949):223-5 18.Khakoo G A, Lack G. Recommendations for using MMR vac-cine in children allergic to eggs. BMJ 2000;320(7239):929932 19.Cerecedo Carballo I, Dieguez Pastor MC, Bartolomé Zava-la B, Sánchez Cano M, de la Hoz Caballer B. Safety of me-asles-mumps-rubella vaccine (MMR) in patients allergic toeggs. Allergol Immunopathol (Madr). 2007 May-Jun;35(3):105-9. 20.James JM, Burks AW, Roberson PK, Sampson HA.Safe admi-nistration of the measles vaccine to children allergic to eggs.N Engl J Med. 1995 May 11;332(19):1262-6. 21.Freigang B, Jadavji TP, Freigang DW. Lack of adverse re-actions to measles, mumps, and rubella vaccine in egg-aller-gic children. Ann Allergy. 1994 Dec;73(6):486-8. 22.Kelso JM1, Jones RT, Yunginger JW. Anaphylaxis to meas-les, mumps, and rubella vaccine mediated by IgE to gelatin.J Allergy Clin Immunol. 1993 Apr;91(4):867-72 23-Andersen DV, Jørgensen IM. MMR vaccination of children withegg allergy is safe. Dan Med J. 2013 Feb;60(2):A4573. 24.Tan MS, Teoh EJ, Hor CP, Yeoh AA.Measles-Mumps-Rubel-la vaccine for children with egg allergy: Is admission for in-patient vaccination necessary? Med J Malaysia. 2016Aug;71(4):157-160. 25.Cronin J, Scorr A, Russell S, McCoy S, Walsh S, O'SullivanR. A review of a paediatric emergency department vaccina-tion programme for patients at risk of allergy/anaphylaxis. ActaPaediatr. 2012 Sep;101(9):941-5 26.Fina Avilés F, Campins Martí M, Martínez Gómez X, Rodri-go Pendás JA, Lushchenkova O, Pimós Tella L. MMR vacci-ne and egg allergy. Experience in a hospital immunization unit.An Pediatr (Barc). 2007 Oct;67(4):362-7. 27.Yavuz ST, Sahiner UM, Sekerel BE, Tuncer A, KalayciO,Sackesen C.Anaphylactic reactions to measles-mumpsru-bella vaccine in three children with allergies to hen’s egg andcow’s milk. Acta Paediatr 2011;100(8):94-6.
Öz
Öz
Ülkemizde rutin aşı programında olan KKK (kızamık-kızamıkçık-kabakulak) aşısının yumurta alerjisi olan çocuklarda uygulanması, ailelerde ve sağlık personelinde, olası meydana gelebilecek alerjik reaksiyonlar nedeniyle gereksiz kaygı oluşturmaktadır. Bu hastalar KKK aşıları yapılması için alerji kliniklerine yönlendirilmektedirler. Ayrıca daha önce uygulanan aşı sonrasında, alerjik reaksiyon gelişen hastalar da tanısal testlerin (spesifik immünglobulin E (spIgE), deri prik ve intradermaltest) yapılması için yine alerji kliniklerine başvurmaktadırlar. Sağlık Bakanlığı 2008‘Genişletilmiş Bağışıklama Programı Genelgesi’nde KKK aşısı için, jelatin ve neomisin ile anafilaksi, yumurta ile anafilaksi veya anafilaktoid reaksiyon kesin kontrendikasyon olarak bildirilmekte, ‘anafilaksi dışındaki yumurta alerjileri engel değildir’ ibaresi bulunmaktadır. Red Book (Kırmızı Kitap)’ta yumurta alerjisi olan hastalarda (ciddi hipersensitivite öyküsü olsa bile) anafilaktik reaksiyon için riskin düşük olduğu, oluşan reaksiyonların daha çok jelatin gibi aşı komponentlerine bağlı olduğu bildirilmiştir. Fakat daha önce yapılan aşı sonrasında alerjik reaksiyon gelişenhastaların bir alerjist tarafından sonraki doz uygulamaları için değerlendirilmesi gerektiği belirtilmiştir.
Anahtar Kelimeler
Yumurta Alerjisi Kızamık Kızamıkçık Kabakulak Aşısı DeriPrick Test İntradermal Test
Kaynakça
- Kaynaklar 1.Sicherer SH, Sampson HA.Food allergy: A review and upda-te on epidemiology, pathogenesis, diagnosis, prevention, andmanagement.J Allergy Clin Immunol. 2018 Jan;141(1):41-58. 2.EAACI Food Allergy and Anaphylaxis Guidelines Group.Al-lergy. 2014 Aug;69(8):1008-25. doi: 10.1111/all.12429.Epub 2014 Jun 9. 3.Ovomucoid specific immunoglobulin E as a predictor of to-lerance to cooked egg. Lisa M. Bartnikas, M.D.1,2 WilliamJ. Sheehan, M.D.,1,2 Katherine L. Tuttle, M.D.,2,3 Carter R.Petty, M.A.,4 Lynda C. Schneider, M.D.,1,2 and Wanda Phi-patanakul, M.D., M.S.1, Sicherer SH, Sampson HA. Food al-lergy. J Allergy Clin Immunol 2006; 117(2 Suppl Mini-Pri-mer): S470. 4.Cerecedo Carballo I, Dieguez Pastor MC, Bartolomé Zava-la B, et al. Safety of measles-mumps-rubella vaccine (MMR)in patients allergic to eggs. Allergol et Immunopathol 2007;35(3):105-9. 5.McLean HQ, Fiebelkorn AP, Temte JL, Wallace GS, Centersfor Disease Control and Prevention. Prevention of measles,rubella, congenital rubella syndrome, and mumps, 2013: sum-mary recommendations of the Advisory Committee on Immu-nization Practices (ACIP). MMWR Recomm Rep 2013;62(RR-04):1. 6.Chow WC, Eyw K, Lau YL. Measles-mumps-rubella vaccina-tion and egg allergy. HKJ Pediatr 2003;8:35-39 7.Dreskin SC, Halsey NA, Kelso JM, et al. International Con-sensus (ICON): allergic reactions to vaccines. World AllergyOrganization Journal 2016;9:32. 8.Elliman D, Dhanraj B. Safe MMR vaccination despite neomycinallergy. Lancet. 1991;337:365. 9.Kwittken PL, Rosen S, Sweinberg SK. MMR vaccine and neo-mycin allergy. Am J Dis Child. 1993;147:128–9. 10.Van Asperen PP, McEnlery J, Kemp AS. Immediate reactionsfollowing live attenuated measles vaccine. Med J Aust.1981;2:330–1. 11.McEwan J. Early-onset reaction after measles vaccination –Further Australian reports. Med J Aust. 1983;2:503–5. 12.Kemp A, Van Asperen P, Mukhi A. Measles immunization inchildren with clinical reactions to egg protein. Am J Dis Child.1990;144:33–5. 13.Nakayama T, Aizawa C, Kuno-Sakai H. A clinical analysis ofgelatin allergy and determination of its causal relationship tothe previous administration of gelatin-containing acellular per-tussis vaccine combined with diphtheria and tetanus toxoids.J Allergy Clin Immunol 1999; 103: 321-5. 14.Czajka H, Schuster V, Zepp F, Esposito S, Douha M, WillemsP. A combined measles, mumps, rubella and varicella vacci-ne (PriorixTetra): Immunogenicity and safety profile. Vacci-ne 2009; 27: 6504-11. 15.MMR and MMR vaccines Kowalzik F, Faber J, Knuf M.Vac-cine. 2017 Jul 27. pii: S0264-410X(17)30959-3. 16.Baxter DN. Measles immünization in children with a historyof egg allergy. Vaccine 1996;14:131-134 17.Aickin R, Hill D, Kemp A. Measles immunisation in childrenwith allergy to egg. BMJ 1994;309(6949):223-5 18.Khakoo G A, Lack G. Recommendations for using MMR vac-cine in children allergic to eggs. BMJ 2000;320(7239):929932 19.Cerecedo Carballo I, Dieguez Pastor MC, Bartolomé Zava-la B, Sánchez Cano M, de la Hoz Caballer B. Safety of me-asles-mumps-rubella vaccine (MMR) in patients allergic toeggs. Allergol Immunopathol (Madr). 2007 May-Jun;35(3):105-9. 20.James JM, Burks AW, Roberson PK, Sampson HA.Safe admi-nistration of the measles vaccine to children allergic to eggs.N Engl J Med. 1995 May 11;332(19):1262-6. 21.Freigang B, Jadavji TP, Freigang DW. Lack of adverse re-actions to measles, mumps, and rubella vaccine in egg-aller-gic children. Ann Allergy. 1994 Dec;73(6):486-8. 22.Kelso JM1, Jones RT, Yunginger JW. Anaphylaxis to meas-les, mumps, and rubella vaccine mediated by IgE to gelatin.J Allergy Clin Immunol. 1993 Apr;91(4):867-72 23-Andersen DV, Jørgensen IM. MMR vaccination of children withegg allergy is safe. Dan Med J. 2013 Feb;60(2):A4573. 24.Tan MS, Teoh EJ, Hor CP, Yeoh AA.Measles-Mumps-Rubel-la vaccine for children with egg allergy: Is admission for in-patient vaccination necessary? Med J Malaysia. 2016Aug;71(4):157-160. 25.Cronin J, Scorr A, Russell S, McCoy S, Walsh S, O'SullivanR. A review of a paediatric emergency department vaccina-tion programme for patients at risk of allergy/anaphylaxis. ActaPaediatr. 2012 Sep;101(9):941-5 26.Fina Avilés F, Campins Martí M, Martínez Gómez X, Rodri-go Pendás JA, Lushchenkova O, Pimós Tella L. MMR vacci-ne and egg allergy. Experience in a hospital immunization unit.An Pediatr (Barc). 2007 Oct;67(4):362-7. 27.Yavuz ST, Sahiner UM, Sekerel BE, Tuncer A, KalayciO,Sackesen C.Anaphylactic reactions to measles-mumpsru-bella vaccine in three children with allergies to hen’s egg andcow’s milk. Acta Paediatr 2011;100(8):94-6.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Bölüm | makale |
| Yazarlar | |
| Yayımlanma Tarihi | 6 Mart 2018 |
| Yayımlandığı Sayı | Yıl 2018 Cilt: 10 Sayı: 2 |
