Adverse reactions to vaccines practice parameter 2012 update
Adverse reactions to vaccines practice parameter 2012 update
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DOI：
10.1016/j.jaci.2012.04.003
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发表时间：
2012-07-01
影响因子：
14.2
通讯作者：
Wallace, Dana
中科院分区：
文献类型：
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作者：
Kelso, John M.;Greenhawt, Matthew J.;Wallace, Dana
接种疫苗后轻微的局部反应和发热是常见的，并不禁忌未来的剂量。对疫苗的过敏反应是罕见的，应通过对疫苗及其成分的皮肤试验进行评估。如果皮肤试验结果为阴性，则可以以常规方式但在观察下给予后续剂量。如果皮试结果呈阳性，患者需要后续接种，可在观察下分阶段接种疫苗。对疫苗的一些非过敏性反应也需要评估，但只有少数是未来剂量的禁忌症。孕妇和免疫力低下的人一般不应接种活疫苗。所谓的疫苗接种的长期后遗症，如自闭症，并没有得到流行病学研究的支持。任何严重程度的鸡蛋过敏患者都应每年接种流感疫苗，因为研究表明反应率非常低。迄今为止的研究已经评估了可注射的三价流感疫苗（TIV），因此TIV，而不是减毒活流感疫苗（LAIV），应用于鸡蛋过敏的接受者。在美国，所有可用的流感疫苗都含有少量的卵清蛋白。既不需要用疫苗进行皮肤试验，也不需要分剂量接种;但是，疫苗应在可以识别和治疗过敏反应的环境中接种。
Mild local reactions and fever after vaccinations are common and do not contraindicate future doses. Anaphylactic reactions to vaccines are rare and should be evaluated with skin tests to the vaccine and its components. If the skin test results are negative, subsequent doses can be administered in the usual manner but under observation. If the skin test results are positive and the patient requires subsequent doses, the vaccine can be administered in graded doses under observation. Some nonanaphylactic reactions to vaccines might also require evaluation, but only a few are contraindications to future doses. Pregnant women and persons who are immune compromised should generally not receive live vaccines. Purported long-term sequelae of vaccination, such as autism, are not supported by epidemiologic studies. Patients with egg allergy of any severity should receive annual influenza vaccinations because studies have demonstrated a very low rate of reactions. Studies to date have evaluated the injectable trivalent influenza vaccine (TIV), and thus TIV, rather than the live attenuated influenza vaccine (LAIV), should be used for recipients with egg allergy. All influenza vaccines available in the United States contain low amounts of ovalbumin. Neither skin testing with the vaccine nor dividing the dose is required; however, the vaccine should be administered in a setting in which anaphylaxis can be recognized and treated.