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Having worked in children’s wards around different parts of the country I’ve had many occasions of children attending day case units for vaccination as parents were concerned about “severe” reactions to previous vaccinations and the request from the GP to vaccine the child in hospital (with a pre-emptive cannula and pre-emptively drawn up syringes of the anaphylaxis medications) always states “previous anaphylactic reaction to vaccine”. This makes a simple vaccination a whole day affair for the family and after cannulation and then a period of forced observation leaves the child understandably scared about future vaccines.
I was therefore interested to read the article in the June ADC “Anaphylaxis as an adverse event following immunisation in the UK and Ireland”.
The study uses BPSU (British Paediatric Surveillance Unit) data gathered over a 13 month period to assess the occurrence of anaphylaxis after childhood vaccinations. In total out of the 15 cases reported, 7 met the criteria for anaphylaxis - 6 required treatment with IM adrenalin and one recovered spontaneously.
None of the cases occurred with the infant or preschool vaccine programmes (with an estimated 5.5 million receiving these vaccines during the study period). 2 of the cases were associated with the single component measles vaccine, and 3 with the HPV vaccine programme.
Although the BPSU is a well-recognised system of reporting of rare occurrences and the monthly return rates for the reporting cards were over 90% it may be argued that some cases may have been missed.
Whilst there is more to “adverse reactions” than simply anaphylaxis, this data should be reassuring to clinicians and parents and I would encourage GPs and Paediatricians alike to seriously consider the request for vaccination in hospital in future.
- What further work needs to be done?
- Will this paper change your practice around vaccination?