Anaphylaxis Complicating Routine Childhood Immunization: Hemophilus Influenza b Conjugated Vaccine

Abstract

Increasing numbers of vaccines are being introduced into the infant and childhood immunization schedules. Immediate hypersensitivity reactions to include anaphylaxis can occur during the immunization visit. Determining the cause of a vaccine-associated immediate hypersensitivity reaction may require multiple specific skin test and challenge procedures. We report the case of a 4-month-old Caucasian male who developed an urticarial rash within 10 minutes of receiving his 4-month immunizations, diphtheria-tetanus-acellular pertussis (DTaP), inactivated polio (IPV), and the diphtheria mutant protein (CRM197) conjugated Hemophilus influenzae type b (HbOC). The child was referred for an allergy-immunology consultation in order to determine the cause of the reaction and a future vaccine management strategy. Negative prick skin tests were obtained with full-strength vaccine and subsequent dose challenges with DTaP and IPV vaccines were tolerated without reaction. Prick skin testing with full-strength HbOC was neg...