Vaccination and consultation in an outpatient clinic of allergy and clinical immunology

Overview

Allergologists and clinical immunologists are by the law responsible for permanent contraindications of immunizations. They should exclude the possibility of developing a serious allergic reaction or the presence of a serious immunodeficiency before the application of live vaccines. The application of a vaccine after which a serious allergic reaction developed in the past is one of the permanent contraindications, it is also not allowed to use vaccines which contain a compound after which a serious allergic reaction had already developed. Gelatine, egg protein, antibiotics – neomycin, kanamycin, streptomycin, polymyxin B, yeast allergens and tetanus anatoxin alone are considered to be very probably responsible for anaphylactic reactions. A live vaccine must not be given to a person with severe primary or secondary immunodeficiency according to “The Position Papers WHO” for individual vaccines. There is nearly no risk to apply a live vaccine to an adult person with primary immunodeficiency, which is manifested in infancy. Most of the serious primary immunodeficiencies are revealed by the examination of the differential blood count and by the measurement of levels of IgG, IgA, and IgM class immunoglobulins.

Key words:
vaccination – allergic reactions – immunodeficiency – autoimmunity.