News & Views: Vaccines and Allergies

Recently, we have had a spate of questions related to vaccines and allergies, so we thought it might be helpful to provide some additional information.

Peanut allergies – Children with peanut allergies do not need to forego any immunizations that might elicit a reaction.

Corn allergies – Similarly to peanut allergies, children with corn allergies are able to get all vaccines.

In the case of both peanut and corn allergies, the issue would be the oils contained in these products; however, neither of these oils are contained in vaccines. Some oil-in-water emulsions have been studied for use as adjuvants; however, a limited number have been licensed for use in Europe and none is approved for use in the United States. The European products contain squalene which is isolated from shark liver oil and is also produced in the human liver.

Egg allergies – Although people with egg allergies were previously cautioned against getting the influenza vaccine, current influenza vaccine products contain sufficiently fewer quantities of egg proteins than in the past. Therefore, only those with the most severe egg allergies (life-threatening) are cautioned about receipt. The 2013-2014 influenza season was the first in which a completely egg-free product, FluBlok®, was available.

Egg allergies are still a contraindication for receipt of the yellow fever vaccine. Someone with an egg allergy who is in need of the vaccine should consult with an allergist.

Gelatin allergies – Gelatin is used in some vaccines as a stabilizer. The type of gelatin in vaccines is derived from pigs, whereas the type of gelatin in most foods comes from cows. However, people with severe gelatin allergies have had reactions to vaccines. In fact, it is the vaccine ingredient responsible for the largest percentage of identifiable reactions. One anaphylactic reaction caused by gelatin occurs in about every 2 million doses of vaccine.

Vaccines containing gelatin and the quantity per dose are offered on the gelatin-specific page on our website.

Other food allergies – Yeast proteins are contained in vaccines including Pediarix® (< 5 percent), Twinrix® (< 5 percent), Energix® B (< 5 percent), Recombivax® (< 1 percent) and Gardasil® (< 7 mg). Vaccines that contain lactose include Hiberix® (12.6 mg per dose), Menomune® (2.5 to 5 mg) and Vivotif® (180 to 200 mg).

Latex allergies – Some vaccines are supplied in latex-containing packaging. Only those individuals with life-threatening (anaphylactic) allergies need to take precautions. In these cases, if it is determined that the risk of disease is greater than the risk associated with vaccination, the healthcare provider administering the vaccine should be prepared to respond to a reaction.

The CDC compiled a list of vaccines that contain latex and the part of the package that is affected. It is available in Appendix B of “Epidemiology and Prevention of Vaccine-Preventable Diseases (Pink Book) and has been updated online.

Antibiotics – During the manufacturing process, antibiotics are sometimes used to prevent contamination of vaccines. In some cases residual antibiotics remain; however, the antibiotics used in vaccines (neomycin, polymyxin B and gentamicin) tend to be different than those to which people experience allergic reactions (penicillins, cephalosporins and sulfa drugs). Additionally, most vaccines contain minimal to no antibiotics.

The vaccine ingredients – antibiotics page on the VEC website includes a summary table of the quantities of antibiotics in vaccines.

Resources

• Peanut and corn oils
• Adjuvants
• Egg allergies
• Gelatin allergies
• Yeast allergies
• Antibiotics