Suspected neomycin sensitivity and MMR vaccination
Question:
9/10/2019
Is there a risk of administering MMR in a patient with neomycin sensitivity?
Answer:
Most immunologically-mediated neomycin hypersensitivity is T-cell mediated. The amount of neomycin in an MMR vaccine is extremely small. There is virtually no risk of an acute onset systemic IgE-mediated hypersensitivity reaction from neomycin. A small amount of intramuscular T-cell mediated activation is also typically of no clinical significance and may actually provide a slight adjuvant effect and make the vaccination more effective. I would administer the MMR vaccination, even if the individual was patch test positive to neomycin, because the benefit of the MMR vaccination would greatly outweigh any risk of a local rash.
I hope this information is of help to you and your patient.
Regards,
Eric Macy, MD, MS, FAAAAI