Anaphylaxis To Oral Poliovirus Vaccine In Children With Cow’s Milk Protein Allergy

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

san francisco

Congreso; Annual Meeting American Academy of Allergy and Clinical Immunology; 2011

American Academy of Allergy and Clinical Immunology

  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. METHODS: 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 0.25 mg proteins, OPV, egg, saline and histamine. Patient specific serum IgE was assessed by immunoblotting and ELISA for OPV, CMP and ALA in 2 sera. RESULTS: 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). Immunoblotting 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. CONCLUSIONS: We provided enough evidence to assume that the presence of 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 patients.