Risk of anaphylaxis after vaccination of children and adolescents

Kari Bohlke, Robert Davis, S. M. Marcy, M. M. Braun, Frank DeStefano, Steven B. Black, John P. Mullooly, Robert S. Thompson

Research output: Contribution to journalArticle

222 Citations (Scopus)

Abstract

Objective. To quantify the risk of anaphylaxis after vaccination of children and adolescents. Methods. The study population consisted of children and adolescents who were enrolled at 4 health maintenance organizations that participated in the Vaccine Safety Datalink Project. For the period 1991-1997, we identified potential cases by searching for occurrences of International Classification of Diseases, Ninth Revision (ICD-9) code 995.0 (anaphylactic shock), E948.0 through E948.9 (adverse reaction from bacterial vaccines), and E949.0 through E949.9 (adverse reaction from other vaccines and biological substances). At 1 study site, we also included a range of other allergy codes. We restricted to diagnoses on days 0 to 2 after vaccination (ICD-9 995.0) or day 0 (all other ICD-9 codes). We then reviewed the medical record to confirm the diagnosis. Results. We identified 5 cases of potentially vaccine-associated anaphylaxis after administration of 7 644 049 vaccine doses, for a risk of 0.65 cases/million doses (95% confidence interval: 0.21-1.53). None of the episodes resulted in death. Vaccines that were administered before the anaphylactic episodes were generally given in combination and included measles-mumps-rubella, hepatitis B, diphtheria-tetanus, diphtheria-tetanus-pertussis, Haemophilus influenzae type b, and oral polio vaccine. One case of anaphylaxis followed measles-mumps-rubella vaccine alone. At the site at which we reviewed additional allergy codes, we identified 1 case after 653 990 vaccine doses, for a risk of 1.53 cases/million doses (95% confidence interval: 0.04-8.52). Conclusions. Patients and health care providers can be reassured that vaccine-associated anaphylaxis is a rare event. Nevertheless, providers should be prepared to provide immediate medical treatment should it occur.

Original languageEnglish (US)
Pages (from-to)815-820
Number of pages6
JournalPediatrics
Volume112
Issue number4
DOIs
StatePublished - Oct 1 2003
Externally publishedYes

Fingerprint

Anaphylaxis
Vaccination
International Classification of Diseases
Vaccines
Diphtheria
Tetanus
Hypersensitivity
Measles-Mumps-Rubella Vaccine
Confidence Intervals
Bacterial Vaccines
Haemophilus influenzae type b
Mumps
Rubella
Health Maintenance Organizations
Whooping Cough
Measles
Poliomyelitis
Hepatitis B
Health Personnel
Medical Records

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Bohlke, K., Davis, R., Marcy, S. M., Braun, M. M., DeStefano, F., Black, S. B., ... Thompson, R. S. (2003). Risk of anaphylaxis after vaccination of children and adolescents. Pediatrics, 112(4), 815-820. https://doi.org/10.1542/peds.112.4.815

Risk of anaphylaxis after vaccination of children and adolescents. / Bohlke, Kari; Davis, Robert; Marcy, S. M.; Braun, M. M.; DeStefano, Frank; Black, Steven B.; Mullooly, John P.; Thompson, Robert S.

In: Pediatrics, Vol. 112, No. 4, 01.10.2003, p. 815-820.

Research output: Contribution to journalArticle

Bohlke, K, Davis, R, Marcy, SM, Braun, MM, DeStefano, F, Black, SB, Mullooly, JP & Thompson, RS 2003, 'Risk of anaphylaxis after vaccination of children and adolescents', Pediatrics, vol. 112, no. 4, pp. 815-820. https://doi.org/10.1542/peds.112.4.815
Bohlke K, Davis R, Marcy SM, Braun MM, DeStefano F, Black SB et al. Risk of anaphylaxis after vaccination of children and adolescents. Pediatrics. 2003 Oct 1;112(4):815-820. https://doi.org/10.1542/peds.112.4.815
Bohlke, Kari ; Davis, Robert ; Marcy, S. M. ; Braun, M. M. ; DeStefano, Frank ; Black, Steven B. ; Mullooly, John P. ; Thompson, Robert S. / Risk of anaphylaxis after vaccination of children and adolescents. In: Pediatrics. 2003 ; Vol. 112, No. 4. pp. 815-820.
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