Pertussis reaction
Question:
8/20/2020
I have a 33 year-old male who claims to have a h/o severe allergic reaction to Pertussis vaccine. He states that he had large local swelling and generalized hives when he had his first DPT vaccine. He received DT vaccines after that w/o any issues. He has had MMR, Hep B, Influenza, Meningitis vaccine w/o any issues. He has no food allergies. He has a grandchild who he wants to be around thus would like to get a Pertussis vaccine. What would be the next best step?
Answer:
In evaluation of vaccine reaction there are several steps to consider. If helpful, one could check titers to the antigen involved to understand if there is sufficient protection present. If vaccination is indicated then one could consider skin testing to the vaccine in question (although there is limited data on this step) and / or one could consider a graded challenge / administration of the vaccine needed. It possible it may be helpful to understand what vaccine was used in the past to see if one of the components could have been etiology in the reported reaction - although I recognize that this information is sometimes not available. Here (https://www.aaaai.org/Aaaai/media/MediaLibrary/PDF%20Documents/Practice%20and%20Parameters/Advers-reactions-to-vaccines-2012.pdf) is the practice parameter in evaluation of vaccine reactions which is very helpful resource.
I hope this is helpful.
Andrew Murphy, MD, FAAAAI