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How common are long-lasting, intensely itching vaccination granulomas and contact allergy to aluminium induced by currently used pediatric vaccines? A prospective cohort study
Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. University of Gothenburg, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Allergy Center.
Linköping University, Department of Clinical and Experimental Medicine, Division of Inflammation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Dermatology and Venerology.ORCID iD: 0000-0001-8336-9767
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2014 (English)In: European Journal of Pediatrics, ISSN 0340-6199, E-ISSN 1432-1076, Vol. 173, no 10, 1297-1307 p.Article in journal (Refereed) Published
Abstract [en]

The frequency of long-lasting, intensely itching subcutaneous nodules at the injection site for aluminium (Al)-adsorbed vaccines (vaccination granulomas) was investigated in a prospective cohort study comprising 4,758 children who received either a diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (Infanrix®, Pentavac®) alone or concomitant with a pneumococcal conjugate (Prevenar). Both vaccines were adsorbed to an Al adjuvant. Altogether 38 children (0.83 %) with itching granulomas were identified, epicutaneously tested for Al sensitisation and followed yearly. Contact allergy to Al was verified in 85 %. The median duration of symptoms was 22 months in those hitherto recovered. The frequency of granulomas induced by Infanrix® was >0.66 % and by Prevenar >0.35 %. The risk for granulomas increased from 0.63 to 1.18 % when a second Al-adsorbed vaccine was added to the schedule. Conclusion: Long-lasting itching vaccination granulomas are poorly understood but more frequent than previously known after infant vaccination with commonly used diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b and pneumococcal conjugate vaccines. The risk increases with the number of vaccines given. Most children with itching granulomas become contact allergic to aluminium. Itching vaccination granulomas are benign but may be troublesome and should be recognised early in primary health care to avoid unnecessary investigations, anxiety and mistrust.

Place, publisher, year, edition, pages
Springer Berlin/Heidelberg, 2014. Vol. 173, no 10, 1297-1307 p.
Keyword [en]
Itching nodule, Granuloma, Contact allergy, Aluminium, Adsorbed vaccines, Child health care
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:liu:diva-107372DOI: 10.1007/s00431-014-2318-2ISI: 000342227700004PubMedID: 24752308OAI: oai:DiVA.org:liu-107372DiVA: diva2:723678
Available from: 2014-06-11 Created: 2014-06-11 Last updated: 2017-12-05

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Bergfors, ElisabetHermansson, GöranNyström Kronander, UllaFalk, Lars

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Bergfors, ElisabetHermansson, GöranNyström Kronander, UllaFalk, Lars
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Department of Medical and Health SciencesFaculty of Health SciencesResearch & Development Unit in Local Health CareDivision of Clinical SciencesDepartment of Paediatrics in LinköpingDivision of Inflammation MedicineAllergy CenterDepartment of Dermatology and Venerology
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European Journal of Pediatrics
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