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Vaccines

Find answers to popular questions about vaccines.

Vaccines
  • Question

    I've been treated by a primary care physician for allergies but I've been told I should see an allergist. What's the difference?

    Answer

    Much like a cardiologist specializes in diagnosing and treating heart ailments, an allergist is a medical doctor (MD) who specializes in the diagnosis and treatment of allergic and immunologic diseases. The allergist is trained to find the source of your suffering and treat it so that you can feel healthy all the time.

    After earning a medical degree, an allergist completes a three-year residency-training program in either internal medicine or pediatrics. Next, the allergist completes two or three more years of study in allergy and immunology.

    In a recent survey, patients who had seen an allergist were nearly three times more likely to say their treatment was effective than those who tried to manage their conditions at home with over-the-counter medicine. Other studies show that asthma patients who are being cared for by an allergist are less likely to visit an emergency room or be hospitalized as a result of their asthma.

  • Question

    I had an egg allergy when I was a kid, around 5-6 years old. Now I’m 33 and no longer seem to have any reaction to eggs. I would like to get a flu shot, but I’ve been told I need to be sure I don’t have an egg allergy. I eat eggs every morning and don’t notice any reaction, so I don’t think I’m allergic anymore. Can I just get the flu shot? What do you suggest?

    Answer

    If you are tolerating eggs daily without symptoms, you are no longer allergic to eggs. If you do not have any skin, stomach, swallowing, throat, or breathing symptoms related to eating eggs; then you do not have to worry about egg allergy. You should get the influenza vaccine annually, and you do not need any special precautions or monitoring. 

  • Question

    I have a serious allergy with hives which make me very itchy. I’ve had the hives for the last 10-15 years. Sometimes it goes away for a few years, but it came back this year. When the hives began I took EVIL, and then one doctor suggested ALLEGRA-150. After some time, my doctor suggested ALLEGRA-180. This year, ALLEGRA stopped working on my hives. Now he has given me PETADIN and some antibiotics. Any suggestions to help me get this under control?

    Answer

    Chronic urticaria (hives) can be very frustrating and challenging to control. Nonsedating anti-H1 antihistamines are the mainstay of treatment for chronic urticaria. If these agents are ineffective, higher dosages may be tried, or other agents such as sedating antihistamines, anti-inflammatory agents, and sulfones may be attempted. For many urticaria patients, avoidance of mental stress, alcohol, nonsteroidal anti-inflammatory drugs (NSAIDs), and tight-fitting garments is recommended. You should discuss your symptoms, an evaluation tailored to you, and potential strategies for managing symptoms with your allergist.

  • Question

    Due to nasal allergies, I sometimes have thick nasal mucus that is really bothersome. Is there something I can do to relieve this without a prescription?

    Answer

    An easy home remedy that can help with thick mucus in the nose and sinuses is called “saline lavage,” also sometimes called “saline rinse.” Saline is essentially salt water.

    All you need is a teaspoon of non-iodized salt, a pinch of baking soda, a cup of body-temperature distilled water and an ear bulb syringe – the same kind used to clear out a baby’s nose. (Neti pots and other devices can also be used to deliver this saline solution, but you should discuss with your physician first.) Note that homemade saline solution should be freshly made each time it is used!

    Mix the salt and baking soda in the warm water. Squeeze this mixture into the ear bulb syringe, and then gently squirt it up into each nostril. If you sniff it instead, you may experience a burning sensation, although this technique may help loosen some of the mucus. The fluid will then run back out your nose or, if your head is tilted back, down the back of your throat. Do this (over a sink) to both sides of your nose.

    Don’t overdo it! Unless your physician instructs you otherwise, it is best to only to lavage two (or fewer) times a day.

  • Question

    Will oral antihistamines take care of all my allergy symptoms?

    Answer

    Oral antihistamines relieve many of the allergy symptoms by blocking histamine, the chemical “culprit” that causes many symptoms.

    Antihistamines are classified by number – depending on what antihistamine receptor is blocked on cells – as H1, H2, and (more recently discovered) H3 and H4. The H1 and H4 receptors are associated with capillaries and nerves, such as in the nose or skin, and H2 receptors are found in the lining of the stomach.

    Even the best antihistamines do not offer anything in terms of permanent relief, nor do they relieve nasal congestion. Rather, they temporarily relieve symptoms such as: sneezing, itching, nasal drainage and hives.

    Older (first generation) antihistamines tend to have drawbacks that include being short-acting (measured in hours), and causing drowsiness, making it difficult to concentrate. Newer (second generation) antihistamines, many of which are now over the counter, are not as likely to cause this problem. Most of us think of histamine negatively, since we associate it with allergic reactions. However, histamine is actually a chemical which helps nerve cells communicate, allowing our brains to work properly. An antihistamine, therefore, can block the normal way our brains function (causing those side effects). Newer antihistamines, fortunately, do not get into the brain as readily, and so you may experience less side effects while taking them.

  • Question

    I thought the flu vaccine changed every year, but my nurse looked at this year’s flu vaccine and found it has H1N1 in it. Isn’t that the same as swine flu?

    Answer

    Your nurse is right! The terminology is a little confusing, so here’s a refresher: H1N1 is a subtype of Influenza A that has caused roughly half of all human flu infections we’ve seen in the past several years.

    H1N1 viruses are identified by two surface proteins: Hemagglutinin (H) and Neuramidase (N). The strains H1, 2 and 3, and N1 and 2 are found in people – a lot more strains are found in birds and pigs, and can be spread to humans. If a sufficient genetic shift occurs in an animal virus strain, it can then be transmitted person to person.

    Scientists closely monitor the strains infecting humans as well as animals, since crossover to humans may signal the next pandemic influenza.

    Yes, the human influenza strains do shift from year to year, but it is very rare that all three strains in an influenza vaccine change in a single year. Therefore, you will see repeating strains if you watch the vaccines’ contents.

    People need a yearly influenza vaccine for two reasons: the vaccines usually contain new strains each year, and immunity to influenza decreases over time. The yearly vaccine helps keep your immunity strong and ensures that you have resistance to the strains scientists have identified as important for the year.

  • Question

    My 4 year-old son recently had anaphylaxis after the following vaccinations were given at the same time: chickenpox, DTP, polio, and MMR. Immediately after these immunizations in our pediatrician's office, he complained of his throat hurting, was sneezing, drooling, threw up and had red, itchy skin and trouble breathing. He was taken by ambulance to the ER, and treated with shots including epinephrine. In the past, he has had drooling and vomiting after eating a piece of protein chocolate bar and when taking his gummy vitamins, and complained of his throat hurting after eating marshmallows. My son doesn't have any hay fever, and we don't have a family history of allergies. Do you have any idea what could be causing these reactions?

    Answer

    Based on the information you’ve provided, your child’s reactions may be related to gelatin, which is added as a stabilizer to some vaccines and is found in both the MMR (measles-mumps-rubella) and chickenpox (varicella) vaccines. Yellow fever vaccine and rabies vaccine also contain gelatin, but are not part of the routine childhood vaccination schedule. 

    The foods you list also frequently contain gelatin.

    Neomycin, an antibiotic, is another ingredient in some vaccines which can be related to allergic reactions; it can also result in a reaction if used with topical application (as in “triple antibiotic” antibacterial skin creams, sold over-the-counter). 

    Your allergist can evaluate the possibility of a gelatin (or other) allergy and perform testing on your child to confirm. Given the circumstances, any further vaccinations should be held – and foods containing gelatin avoided – until the exact cause of reactions has been determined.

  • Question

    I am a 66 year-old man who was recently discharged from the hospital after a prolonged and resistant bout of pneumonia. After seeing an allergy/immunology doctor for an evaluation of a possible immune deficiency problem, I had some lab studies done. A certain test called gamma globulin came back in the low normal range, but some of the other tests were not quite normal. The allergist recommended that I have a Pneumovax (pneumococcal vaccine) and a tetanus/diptheria/pertussis vaccination and then have some repeat blood tests. Is it really necessary to have both of these vaccines? How do they help to identify if I have an immune problem?

    Answer

    Someone with an immune deficiency is very likely to have low normal or even normal gamma globulin levels but still have an inability to make antibodies to specific organisms such as pneumococcus (a bacteria which can cause pneumonia).

    The blood work you had taken likely showed your allergist that you lacked proper antibodies to specifically fight pneumococcal diseases and that you lacked protection against tetanus and/or diphtheria. The absence of these antibodies does not in itself mean that you have an immune problem. You may have lost the immunity from the diphtheria/tetanus/pertussis that you had as a child, and may simply not have been exposed to many of the pneumococcal organisms that were tested in the blood.

    However, you do need protection against all these organisms – that’s a standard recommendation for all adults over 65! Receiving the vaccines your physician has recommended will likely give you that protection. Repeating the blood tests 4 weeks afer the vaccinations will help your allergist know if your immune system is functioning properly. You really need both vaccinations for protection and to gain necessary information about your immune system. If your body shows an inadequate response to these vaccines, further immune studies and treatment, possibly long-term, may be required.

    These vaccines can be administered at the same time. I would suggest that you follow your allergist’s advice and obtain the vaccines and then the blood tests 4 weeks later.