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John M Kelso

Publications and source records attributed to John M Kelso.

13 recordsLinked to original sources
PubMed2005

Vaccination of yeast sensitive individuals: review of safety data in the US vaccine adverse event reporting system (VAERS).

The preparation of recombinant hepatitis B vaccines involves using cellular cultures of Saccharomyces cerevisiae, otherwise known as baker's yeast. Prior to vaccine licensure, clinical trials were performed to address whether residual yeast proteins in the vaccines could induce anaphylaxis, including testing for IgE anti-yeast antibody levels. 1-2% of subjects had anti-yeast IgE antibodies before immunization, but demonstrated no significant rise in IgE after HBV. We searched reports in the Vaccine Adverse Event Reporting System (VAERS) for those that mentioned a history of allergy to yeast and then reviewed the adverse events described in these reports for potential anaphylactic reactions. Probable anaphylaxis was defined as the presence of one or more dermatologic symptoms and one or more respiratory, gastrointestinal, or cardiovascular symptoms with onset within 4 h of Hepatitis B vaccination. Possible anaphylaxis was defined in one of two ways: (1) cases that described dermatologic or respiratory symptoms (but not both) occurring within 4h of vaccination; or (2) cases that described one or more dermatologic and/or respiratory symptoms occurring 4-12 h post vaccination. Among the 107 reports of pre-existing "yeast allergies," 11 reports described probable or possible anaphylaxis after HBV. Four additional cases were described after other vaccines. The majority of vaccinees who met the case definitions and had a history of yeast allergies were female, ages ranged from 10 to 64, and symptom onset ranged from 15 min to 5 h after vaccination. No deaths were reported. The small number of reports to VAERS may be partly due to health care professionals observing current contraindications by not vaccinating yeast sensitive individuals. Nevertheless, yeast associated anaphylaxis after HBV in sensitized patients appears to be a rare event.

Adverse Drug Reaction Reporting Systems↗
PubMed2004

Vaccination of persons allergic to latex: a review of safety data in the Vaccine Adverse Event Reporting System (VAERS).

Vaccine products currently licensed in the US and other countries are marketed in vials and syringes that may contain natural latex allergens. Little scientific information exists regarding the safety of vaccination of latex-allergic individuals. A review of data within the Vaccine Adverse Event Reporting System (VAERS), a large registry of reported possible vaccine adverse reactions was conducted. A search of the database, which contains >160,000 vaccine adverse event reports, revealed only 28 cases of possible immediate-type hypersensitivity reactions in vaccine recipients with a history of allergy to latex. Given the large number of immunizations administered every year in the US, the reported risk of allergic reactions possibly due to latex contamination of vaccines appears to be very small.

Adolescent↗
PubMed2004

The rate of systemic reactions to immunotherapy injections is the same whether or not the dose is reduced after a local reaction.

BACKGROUND: Even though no studies have shown that local reactions to immunotherapy injections predict subsequent systemic reactions, many protocols continue to call for dose adjustments after local reactions. OBJECTIVE: To determine whether the rate of systemic reactions to immunotherapy injections is affected by dose adjustment after local reactions. METHODS: In our clinic before March 1999, if a patient had a local reaction to an immunotherapy injection, an adjustment was made to repeat or reduce the next dose. From March 1999 on, no such adjustments were made. At our outlying clinics, the adjustment protocol continued. A retrospective review was conducted for shots given from March 1997 to February 2001, recording whether an immunotherapy visit resulted in a systemic reaction. RESULTS: In our clinic, there were 3,250 shot visits from March 1997 to February 1999 (adjustment protocol) and 4,692 visits from March 1999 to February 2001 (no adjustment protocol). The systemic reaction rate during the 2 periods was not different (1.11% vs 0.85%, P = .29). In the outlying clinics, there were 1,138 shot visits from March 1999 to February 2001 (adjustment protocol), and the systemic reaction rate was not different than in our clinic (no adjustment protocol) (0.88% vs 0.85%, P = .86). CONCLUSIONS: The rate of systemic reactions to immunotherapy injections is the same whether or not the dose is adjusted after a local reaction. These dose adjustments are thus unnecessary, and eliminating them lessens chances for errors and decreases the number of shots required to reach a therapeutic dose.

Allergens↗
PubMed2003

Immunization of egg-allergic individuals with egg- or chicken-derived vaccines.

Viruses used in several vaccines are propagated in embryonated eggs. These vaccines contain variable quantities of residual egg or chicken proteins and pose risks when administered to egg- or chicken-sensitive persons. This article highlights differences in how vaccines are prepared, with emphasis on the quantitation of residual egg-derived protein in each vaccine. Published reports on the frequency and severity of these vaccine-induced allergic reactions are reviewed, and an algorithm is provided for the preimmunization evaluation of egg-sensitive persons.

Adult↗
PubMed2002

Recurrence of allergic rhinitis, previously alleviated with allergen immunotherapy, after autologous bone marrow transplant.

BACKGROUND: Several associations between immunoglobulin E and bone marrow transplantation (BMT) have been reported. OBJECTIVE: A patient whose allergic rhinitis (AR) resolved after allergen immunotherapy (AIT) but recurred after the patient received an autologous BMT is reported. METHODS: Allergy skin tests were performed before AIT began and after 4 years of therapy. Skin tests were repeated after a recurrence of symptoms 6 years later after an autologous BMT for breast cancer. RESULTS: Six years of AIT led to a near complete resolution of AR symptoms. Skin tests showed a marked reduction in reactivity to allergens in the AIT. After an additional 6-year symptom-free interval off AIT, symptoms returned after the BMT. Repeat skin tests showed a marked increase in reactivity. CONCLUSIONS: Patients reconstituting their immune systems after autologous BMT may have a recurrence of AR previously suppressed with AIT.

Adult↗
PubMed2002

Prevalence of anti-gelatin IgE antibodies in people with anaphylaxis after measles-mumps rubella vaccine in the United States.

OBJECTIVE: Anaphylaxis after immunization, although rare, is serious and potentially life-threatening. Understanding risk factors for this reaction is therefore important. Gelatin is added to many vaccines as a heat stabilizer. Japanese researchers have demonstrated a strong association between immediate hypersensitivity reactions to measles, mumps, rubella, varicella, and Japanese encephalitis immunizations and subsequent detection of anti-gelatin immunoglobulin E (IgE) antibodies. They suggested that previous receipt by these patients of diphtheria-tetanus-acellular pertussis vaccines with trace amounts of gelatin was responsible for the sensitization. We aimed to assess whether a similar association exists for vaccinees in the United States who reported anaphylaxis after receipt of measles-mumps-rubella (MMR) or measles vaccines and to review recent trends in reporting of hypersensitivity reactions. METHODS: We conducted a retrospective case-control study. Cases of anaphylaxis that met a predefined case definition were identified from the US Vaccine Adverse Event Reporting System (VAERS). Mayo Clinic patients who received MMR vaccine uneventfully served as controls. The study subjects were interviewed to obtain the history of allergies. Sera from study subjects and their matched controls were tested for IgE antibodies to gelatin, whole egg, and vaccine viral antigens using solid-phase radioimmunoassay. Data from the Biologics Surveillance System on annual numbers of doses of MMR and varicella vaccines distributed in the United States were used to evaluate possible changes in reporting of selected allergic adverse events. RESULTS: Fifty-seven study subjects were recruited into the study and interviewed. Of these, 22 provided serum samples for IgE testing. Twenty-seven subjects served as a comparison group and provided a sample for IgE testing; 21 of these completed an allergy history questionnaire. Self-reported history of food allergies was present more frequently in the interviewed study subjects than in the controls, whereas the proportions of people with other characteristics were similar in both groups. None of the interviewed people had a history of food allergy to gelatin. The level of anti-gelatin IgE antibodies was significantly higher among study subjects than among controls, whereas the levels of IgE antibodies against egg and all 3 viral antigens did not differ significantly. Of 22 study subjects, 6 (27%) tested positive for anti-gelatin IgE, whereas none of the 27 controls did. The rate of anaphylactic reactions reported to VAERS after measles virus-containing immunization in the United States between 1991 and 1997 is 1.8 per 1 million doses distributed. No substantial increase in the number of reported allergic events after frequently used gelatin containing MMR and varicella vaccines could be observed during the first 4 years (1997-2000) since the introduction of diphtheria-tetanus-acellular pertussis vaccines for use in infancy. CONCLUSION: Anaphylactic reactions to MMR in the United States are rare. The reporting rate has the same order of magnitude as estimates from other countries. Almost one fourth of patients with reported anaphylaxis after MMR seem to have hypersensitivity to gelatin in the vaccine. They may be at higher risk of developing anaphylaxis to subsequent doses of other gelatin-containing vaccines. These people should seek an allergy evaluation before such immunization.

Anaphylaxis↗