Is cow milk allergy a factor risk to infectious vaccine allergy?

PARISI CLAUDIO; MASPERO JORGE; GERVASONI MARIA EUGENIA; SMALDINI PAOLA; DOCENA GUILLERMO H.

Congreso; 30th Congress of the European Academy of Allergy and Clinical Immunology; 2011

Background: Serious adverse events following oral poliovirus vaccine (OPV) administration are rare, and in particular allergic reactions including anaphylaxis are unknown. In other vaccines the presence of egg proteins or gelatin has been related to allergic reactions in children with food allergies. We report 4 cases of anaphylaxis following OPV administration in children with cow’s milk protein allergy (CMPA) due to the presence of alpha- lactoalbumin (ALA) in the vaccine. Method: Four children with previous diagnosis of CMPA experienced anaphylactic reactions after they received the OPV during a National Immunization Program against poliovirus carried out in Argentina during 2009. The OPV used in the campaign (Polioral ®) contained up to 25 mg/ml of ALA as stabilizer. Patients and healthy adult controls were studied after the episodes by means of skin prick tests with different cow milk proteins, OPV, egg, saline and histamine. Patient specific serum IgE was assessed by ELISA for OPV, CMP and ALA in 3 sera. Result: While controls were uniformly negative all patients showed a strongly positive skin prick test with OPV (mean papule diameter 5.25mm), ALA (14.12 mm). ELISA showed the presence of specific IgE against different CMP and ALA, even in the OPV. ELISA assays also detected serum specific IgE antibodies against ALA in CMP and in OPV. Conclusion: Alpha-lactoalbumin in the composition of this brand of OPV caused anaphylactic reactions in children with known CMPA. This suggests that ALA-containing brands of OPV should be avoided in these