How to manage anaphylaxis and allergy after vaccination

Post-vaccination reactions are usually systemic symptoms associated with skin manifestations such as erythema, Quincke edema, urticaria or respiratory tract, including rhinitis - conjunctiva, bronchospasm.

According to the Guidelines for Diagnosis and Treatment of Allergic-Clinical Immunological Diseases issued by the Ministry of Health, the rate of unwanted reactions by vaccines varies between 4.8 and 83 cases / 100,000. vaccine dose. In particular, the rate of allergic reactions is about 1 / 50,000 to 1 / 100,000 injections.

After vaccination, parents need to pay attention to the expression of the child to detect allergic reactions if available for timely management.(Photo: hanoimoi).

Research shows that vaccines and excipients components can cause unwanted effects. Vaccines containing eggs or gelatine have an allergic reaction that is often severe and more frequent . However, anaphylaxis rarely occurs , only about 1 / 1,000,000 doses.

Vaccine side effects are varied, but most are localized at the injection site, as a result of nonspecific inflammation due to vaccine components such as aluminum salts. There is currently no evidence to confirm an increased risk of vaccine response in people with allergic sites (atop).

Local mild reactions or fever after vaccination usually occur and there is no contraindication to the following vaccinations. However, cases of systemic allergic reactions or anaphylactic shock should be examined, exploited a history of allergies, tested skin with vaccines and vaccines in order to make a diagnosis and decide what correct treatment in patients who have an immediate reaction to the vaccine.

Comparison of the frequency of side effects of some common vaccines:

Clinical manifestations of vaccine allergic reactions include:

Instant reaction or mediated IgE:

Allergic reactions to the components of the vaccine play a very important role, especially when using vaccines grown in the protein environment from eggs, yeast and alcohol gelatine. Other ingredients in vaccines such as antibiotics, preservatives, fixes, contaminated components such as latex can also be triggers or causes of allergic reactions. However, egg proteins, gelatine and latex are still the most common causes of immediate allergic reactions.

Signs of an immediate allergic reaction after injection or vaccination are usually systemic symptoms associated with skin manifestations such as erythema, Quincke edema, urticaria, respiratory symptoms such as rhinitis, conjunctivitis. bronchial or bronchospasm. Besides, there are also cardiovascular complications with fatigue, dizziness and hypotension. It may even fall into a state of shock within minutes.

Symptoms of anaphylaxis usually occur within 4 hours after vaccination. A patient is diagnosed with anaphylaxis when at least one of the 4 signs is present at the following agencies:

1. Skin manifestations: Urticaria, angioedema (Quincke edema), pruritus and vasodilation.
2. Inhalation: nasal congestion, runny nose, congestion of the nasal mucosa, wheezing breathing due to oropharyngeal edema and larynx or symptoms of lower respiratory tract such as wheezing, wheezing, chest tightness, shallow breathing, Severe respiratory failure may occur.
3. Cardiovascular: Hypotension, rapid heart rate, pale, severe skin may stop the heart.
4. Gastrointestinal manifestations: Vomiting, nausea, abdominal cramps, severe pain may be incontinence.

Allergic reactions to the components of the vaccine are very important.

Local reactions and delayed hypersensitivity:

1. Slow reactions to vaccines often manifest at the injection site.These reactions are not classified as allergic reactions but are often the result of nonspecific inflammatory reactions caused by components such as aluminum salts or microorganisms.They are often called activating factors.
2. Arthus:These reactions usually progress after 6 to 12 hours in the presence of high concentrations of antibodies, even progressing to a few days later like serum sickness.Consequences of acute inflammatory processes can lead to organizational destruction with several symptoms that have serum disease-like mechanisms including arthritis and fever.
3. Slow hypersensitivity reactions:Intermediate T-cell-mediated reactions often show localized ezema, which starts 2 to 8 hours after 2 days.Sometimes the reaction may also be more widespread and systemic manifestations such as erythema multiforme, AGEP syndrome with high fever, acute pustular rash after vaccination.
4. Symptoms oflocalized pain and swelling may also appear and spread but usually regress after 2 to 4 days without leaving any complications. These cases have no contraindications to vaccination later. Vaccines often cause severe local reactions such as polyclonal pneumococcal vaccines, influenza, whooping cough and especially diphtheria and tetanus and tetanus, hepatitis B. Immune response For tetanus leading to local side effects for about 80% in adults. About 2% of children who get pertussis and tetanus (DTaP) vaccine have local reactions.

Vaccines often cause severe local reactions such as multi-price pneumococcal vaccine, flu, pertussis .

Treatment of allergic reactions after vaccination includes:

If the patient has a local allergic reaction, apply ice at the injection site . In case of severe pain, the doctor may prescribe paracetamol or ibuprofen. If there is an allergic manifestation, topical itching may use oral antihistamine. When symptoms are relieved, patients should be monitored for at least the next 30 minutes.

If the patient has a mild anaphylactic reaction to the usual manifestations of urticaria and angioedema (Quincke), antihistamine is used. If severe symptoms, the whole body, the doctor may consider taking more corticosteroids.