Managing a child with a possible vaccine allergy

Abstract

Adverse reactions to vaccination are frequent, but true allergy to vaccines is rare. It is important to recognize symptoms which are common side effects of immunization and local reactions/benign rashes which are not a contraindication for future vaccination. Patients with a history of significant reactions to vaccines need to be referred for investigation of suspected allergy to the vaccine itself, or, more commonly excipients. Investigations involve allergy testing (skin testing and specific IgE) and ultimately risk – assessed challenge to either the same vaccine or an alternative vaccine without the offending allergen in case of reactions to excipients/adjuvants. In this article, we discuss how to identify children and young people who need further investigation, those who would benefit from onward referral and distinguish them from those who can continue with the immunization schedule in the community or local services.