[Measles vaccination for
children with allergic diseases]
[Article in
Japanese]
Hirokado M, Takamasu T, Takenouchi H, Kotoyori T,
Kurihara K.
Department of Allergy, Kanagawa Children's
Medical Center.
To predict the side effects of vaccination, some
skin tests are performed for patients with allergic diseases, though at
present time there is no standard method. We have performed skin tests
of measles vaccine by prick test with undiluted vaccine, 1 : 10
dilution, and/or intradermal test with 1 : 100 dilution. 75 cases of
children with allergic diseases were assessed with more than two types
of these skin tests. The cases with negative response for the skin tests
were subcutaneously administered with 0.5ml of vaccine at once (normal
method). On the other hand, the cases with positive or+/-response at
least one skin test were subcutaneously administered with the vaccine in
increments of 0.05ml (divided method). Including+/-response, intradermal
test with 1 : 100 dilution showed highest sensitivity (88%) and
relatively high specificity (75%) for the prediction of side effects in
the 3 types of skin tests. Forty nine cases were vaccinated with the
normal method, and 26 cases were vaccinated with the divided method.
Compared with the cases with normal method, the cases with divided
method showed higher frequency for patients with the elimination therapy
of foods besides egg, and significantly higher value of total IgE, and
specific IgE for egg white, cow's milk, wheat, and cat dander. Twenty
five of 26 cases with the divided method showed specific IgE for egg
white>3.5UA/ml, and 8 of 11 cases showed specific IgE for cat
dander>0.35 UA/ml. In 8 cases who appeared side effects (one was
administered by t he normal method, and 7 were administered by the
divided method), 7 cases were local skin reaction only, and there were
no cases of anaphylaxis. We recommend that the intradermal test of
dilution 1: 100 should be performed to determine the vaccination method.
The cases with the elimination therapy of foods besides egg, cases with
specific IgE for egg white>3.5UA/ml, or cases with specific IgE for
cat dander>0.35UA/ml, should be considered as high risk
patients.