Wood et al reported an algorithm for the management of a patient with a possible hypersensitivity reaction to a vaccine. The authors are from the Hypersensitivity Working Group of the Clinical Immunization Safety Assessment Network.
Patient selection: recently vaccinated patient
Parameters:
(1) history consistent with immediate hypersensitivity
(2) history suggests related to vaccine(s)
(3) an additional dose of vaccine indicated
(4) serologic testing (positive, negative, testing not performed)
(5) skin test findings (positive, negative, testing not performed)
(6) high risk for target disease
Consistent with HS
Related to Vaccine
Another dose needed
Serologic test
Skin test
High Risk Target Disease
Box
N
NA
NA
NA
NA
NA
1
Y
N
NA
NA
NA
NA
1
Y
Y
N
NA
NA
NA
2
Y
Y
Y
positive
NA
NA
2
Y
Y
Y
other
positive
Y
4
Y
Y
Y
other
positive
N
2
Y
Y
Y
other
other
NA
3
Box
Interpretation
1
immunize if indicated OR evaluate under causality algorithm (if concerned about reaction severity)
2
no further doses of suspected vaccine(s)
3
reconsider risk benefit analysis (immunize if indicated but observe carefully for reaction)
4
immunize under controlled conditions OR use alternative preventive strategy if available
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