how do we know that a 2 month old getting his/her first DTaP has a milk allergy,
if breastfed and never had milk?
Sent by Dawn Richardson, director of www.NVICAdvacacy.org and PROVE www.vaccineinfo.net
Allergic Reactions to Diphtheria, Tetanus, and Acellular Pertussis Vaccines Among Children with Milk Allergy
J. D. Kattan, A. L. Cox, A. Nowak-Wegrzyn, G. Gimenez, L. Bardina,
H. A. Sampson, S. H. Sicherer;
Mt. Sinai School of Medicine, New York, NY.
RATIONALE: Vaccines containing diphtheria, tetanus, and acellular pertussis
are processed in medium containing casamino acids derived from
cow’s milk; several milk allergic children have reported allergic reactions
following administration of these vaccines.
METHODS: This was a chart review of patients seen in our practice who
had reported allergic reactions after receiving tetanus vaccines (primary or
booster doses) from September 2007 to March 2010. An inhibition-ELISA
was performed to determine the presence of milk protein in the vaccines.
RESULTS:We identified seven patients (5 male, 2 female; median age 11
years; range: 5-17), who reported convincing allergic reactions to tetanus
vaccines. Six patients had prior allergic reactions to cow’s milk, including
severe reactions (5) and or reactions to trace exposures (4); one was diagnosed
with milk allergy based on serologic testing. All patients had elevated
milk specific IgE levels documented within 2 years of their
reactions to the vaccine: 59, 96, and 5 patients >100 kUA/L. Each reported
symptoms consistent with a diagnosis of anaphylaxis promptly after receiving
the vaccine. Symptoms included: wheezing (5/7), urticaria (5/7),
sneezing/nasal congestion (3/7), angioedema (3/7), and repetitive cough
(2/7). Treatments included antihistamines (5/7), epinephrine (3/7), inhaled
beta-agonists (3/7), and corticosteroids (2/7). Assays were performed on 2
different lots of the tetanus, diphtheria, and acellular pertussis vaccine,
confirming the presence of milk protein in one lot (30 ng/mL).
CONCLUSIONS: Vaccines containing tetanus, diphtheria, and acellular
pertussis derived from broths containing casamino acids may present a
risk to persons with severe milk allergy.