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Allergies and vaccination: a myth demystified

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Abstract

Background

Vaccinations are among the commonest and most successful medical measures. Due to the drop in the incidence of vaccine-preventable diseases, rare side effects such as allergic reactions are coming more to the fore. In addition, vaccinations are often associated with the rising prevalence of allergic sensitization and allergic disease. The myth that “vaccinations cause allergies” is being circulated. This article presents the available evidence on the effect of vaccinations on the prevalence of atopic manifestations (sensitization, asthma, allergic rhinitis, food allergy) and atopic dermatitis. Based on position papers, recommendations are given on the approach to vaccinations in children with allergic disease and/or atopic dermatitis as well as on the approach in patients with anaphylactic reactions to vaccines.

Methods

A literature search in PubMed and in the reference lists of the identified articles was conducted.

Results

There is no evidence that vaccinations increase the risk of specific allergic sensitization or the manifestation of allergic diseases either in high-risk patients (atopy, positive family history) or in patients with no family history of atopy. Vaccinations do not cause allergies! According to experts, atopic children can be vaccinated under standard conditions without a mandatory follow-up observation period. Allergy testing should be performed following allergic reactions to vaccines or vaccine components. Follow-up vaccinations after anaphylactic reactions to vaccines or vaccine components should be performed under monitoring conditions by physicians experienced in the recognition and treatment of anaphylactic reactions.

Conclusion

Standard vaccinations do not increase the risk for manifesting allergic disease or specific sensitization to environmental allergens. If individual protection is desired, and taking into account the particular risks and provisos, children with allergic disease and anaphylactic reactions to vaccines can also be vaccinated.

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Abbreviations

BCG:

Bacillus Calmette Guérin (vaccine)

DTP/DTaP:

Diphtheria, tetanus, and pertussis (vaccine); a acellular

EAACI:

European Academy of Allergy and Clinical Immunology

GPA:

German Society for Pediatric Allergology (Gesellschaft für Pädiatrische Allergologie)

HDC:

Human diploid cell lines

IgE:

Immunoglobulin E

ISAAC:

The International Study of Asthma and Allergies in Childhood

KiGGS:

Study on the Health of Children and Adolescents in Germany (Studie zur Gesundheit von Kindern und Jugendlichen in Deutschland)

LAIV:

Live attenuated influenza vaccine

MAS:

Multicenter allergy study

MMR:

Measles, mumps, and rubella (vaccine)

OPV:

Oral polio vaccine

RR:

Riva-Rocci blood pressure measurement

SCIT:

Specific subcutaneous immunotherapy

TBE:

Tick-borne encephalitis

TIV:

Trivalent inactivated influenza vaccine

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Acknowledgements

The authors would like to thank Christoph Grüber for formulating the basis for this work and for kindling the authors’ enthusiasm for the topic allergy and immunization. He is missed.

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Authors and Affiliations

  1. Department of Pediatric and Adolescent Medicine I, University Hospital Schleswig-Holstein, Kiel Campus, Arnold-Heller-Straße 3, House 9, 24105, Kiel, Germany

    Tobias Ankermann

  2. Allergy Campus, Hochgebirgsklinik Davos, Davos Wolfgang, Switzerland

    Thomas Spindler

  3. Department II of Pediatric and Adolescent Medicine, Augsburg Hospital, Augsburg, Germany

    Michael Gerstlauer

  4. Department and Outpatient Clinic for Pediatric and Adolescent medicine, University Hospital Greifswald, Greifswald, Germany

    Sebastian Schmidt

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  1. Tobias Ankermann
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Correspondence to Tobias Ankermann.

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Conflict of interest

T. Ankermann, T. Spindler, M. Gerstlauer and S. Schmidt declare that they have no competing interests.

Additional information

Parts of this article were already published in 2014 (Pädiatrische Allergologie in Klinik und Praxis 2014;17:11–3).

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Ankermann, T., Spindler, T., Gerstlauer, M. et al. Allergies and vaccination: a myth demystified. Allergo J Int 27, 234–243 (2018). https://doi.org/10.1007/s40629-018-0077-8

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