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26 Feb 2018
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L’anafilassi da vaccino è un rischio elevato? Sembrerebbe proprio di no

Dall’esame di 25.173.965 vaccinazioni effettuate nel corso di 3 anni in questo studio sono stati rilevati 33 casi di anafilassi. Tutti guariti. Si conferma che il rischio di anafilassi da vaccino è estremamente basso 1.31 (95% CI, 0.90-1.84) per milione di dosi di vaccino ed è trattabile. Un rischio che vale la pena di correre a fronte degli eccezionali vantaggi che offrono le vaccinazioni.

McNeil MM, DeStefano F. Vaccine-associated hypersensitivity. J Allergy Clin Immunol. 2018 Feb;141(2):463-472. doi: 10.1016/j.jaci.2017.12.971. Review.

Vaccine-associated hypersensitivity reactions are not infrequent; however, serious acute-onset, presumably IgE-mediated or IgG and complement-mediated anaphylactic or serious delayed-onset T cell-mediated systemic reactions are considered extremely rare. Hypersensitivity can occur because of either the active vaccine component (antigen) or one of the other components. Postvaccination acute-onset hypersensitivity reactions include self-limited localized adverse events and, rarely, systemic reactions ranging from urticaria/angioedema to full-blown anaphylaxis with multisystem involvement. Risk of anaphylaxis after all vaccines is estimated to be 1.31 (95% CI, 0.90-1.84) per million vaccine doses, respectively. Serious hypersensitivity reactions after influenza vaccines are particularly important because of the large number of persons vaccinated annually. Influenza vaccines are unique in requiring annual changes in the vaccines’ antigenic composition to match the predicted circulating influenza strains. Recently, novel influenza vaccine types were introduced in the United States (recombinant vaccines, some with higher antigen content and a new adjuvanted vaccine). Providers should be aware of changing recommendations on the basis of recent published evidence for persons with a history of egg allergy to receive annual influenza vaccination. Further research is needed to elucidate the pathophysiology and risk factors for reported vaccine-associated adverse events. Further research is also needed to determine whether repeated annual inactivated influenza vaccination, the number of vaccine antigens administered at the same time, and the current timing of routine infant vaccinations are optimal for overall population well-being.

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