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Vaccines

Find answers to popular questions about vaccines.

Vaccines
  • Question

    What is considered to be an optimal vitamin D level?

    Answer

    The current parameters defining normal vitamin D levels are based on maintaining normal calcium-bone-phosphate homeostasis. There is no universal agreement on what vitamin D levels are ideal in all individuals in all age brackets. The most commonly accepted vitamin D level parameters used by most reference laboratories in the United States are those developed by the Endocrine Society. Whether these cut points represent vitamin D levels for optimal immunomodulatory, antimicrobial, and paracrine function is unknown at this time and is an area being intensively researched.

  • Question

    How often should vitamin D levels be checked?

    Answer

    An annual baseline vitamin D level is considered to be appropriate for the above individuals. If the vitamin D level is low, then a vitamin D supplement should be started and the vitamin D level should be re-checked in 6 to 8 weeks. If the vitamin D blood level has risen to normal, then the vitamin D supplementation should be continued with annual or semi-annual assessment of vitamin D levels.

  • Question

    What's the difference between allergies and asthma?

    Answer

    Allergies are an immune system response, or oversensitivity, to an environmental “trigger” (known as an allergen), such as pollen, dust, mold, pet dander or certain foods, to name a few. Signs of an allergic reaction include frequent or regularly recurring itchy eyes, nose, mouth or ears, sneezing, a runny nose, dry skin or hives, a productive cough, wheezing or tightness in your chest. Allergies can trigger an asthma attack; however, asthma is present in some people without allergies.

    Asthma involves inflammation of the lungs that constricts the muscles around your airways, resulting in chest wheezing, coughing and shortness of breath. The bronchial tubes tighten and air flow is reduced as the lungs expand. While allergens provoke most asthma attacks, other triggers include smoke, cold or humid air, strong odors, and strenuous exercise.

    Allergies and asthma are treatable and the first step is proper diagnosis to pinpoint the source of your symptoms. An allergist is a specialist in diagnosing and treating allergies and asthma.

  • Question

    What's the best way to find out what I'm allergic to?

    Answer

    See an allergist, a physician with additional, specialized training to diagnose, manage and treat allergies and asthma. The doctor will review your health history, give you a physical exam and administer any necessary tests to identify the substances to which you are allergic. Skin tests, for example – a method sensitive to even subtle allergies and which involves exposing your skin to small amounts of allergy – causing substances and watching for reactions – can identify the cause of your suffering and put you on the road to relief.

  • Question

    How do you tell the difference between a cold and allergies?

    Answer

    The biggest clue in deciding whether symptoms like sneezing or a runny nose are a cold or allergies is how long they last. A cold normally lasts about a week, but allergies can last for several weeks or longer—depending on what you are allergic to and how often you are exposed to it.

    Other differences include some of the symptoms. While both can cause a runny or stuffy nose, sneezing and wheezing, you are more likely to have itchy, watery eyes with allergies and get a fever or body aches with a cold. Another clue is your runny nose. If it’s clear, it’s usually related to an allergy and not an infection.

  • Question

    I’m getting ready for my first job. I have asthma, I’m very allergic to mold, and the job is in an old office building. What precautions should I take, and what do you recommend I discuss with my employer about my asthma?

    Answer

    Everyone with asthma and allergies should be able to live a normal life free of symptoms. And if they’re on the right medicines, they should be able to do anything they want to do, including working in any environment.

    Consider first seeing an asthma specialist to make sure your asthma is well controlled and your lung function is normal – before you start the job.

    When you’re starting a new job and are worried about mold allergy, you may want to ask during the interview process to actually see where they will work. It’s not unreasonable to ask the prospective or new employer to look at the work site. If there’s a problem, ask if there’s an opportunity work in a place that is less moldy. For example, telecommuting may be a possibility.

    If the workplace is in an old historic building, the employer may not be able to do very much about mold. It’s difficult to completely eliminate all mold, and it can be expensive to hire a professional contractor, especially for a small business. Mold could be inside air supply ducts, in wall cavities, across ceiling tiles or underneath damp carpets.

    Certainly mold removal is something to discuss with your employer. But if little can be done, then you may want to think about working somewhere else.

  • Question

    Who should have vitamin D blood tests?

    Answer

    Presently, it is not recommended that all individuals have annual vitamin blood tests. However, it is appropriate for certain subsets of the population to have routine assessment of vitamin D levels.

  • Question

    I have a negative reaction to most public pools: I can’t stand the smell, and I get red eyes and a runny nose. I don’t have any trouble breathing, but the smell of the chlorine is intolerable to me. Some pools, especially outdoor pools, do not cause this reaction. My regular physician says this is a sensitivity issue. Is there a test I can have done to confirm whether this is an allergy or not?

    Answer

    Public swimming pools that use chlorine or bromine as disinfectants may be associated with upper and lower respiratory symptoms, as well as skin irritation.

    A recent study of swimmers who practiced in indoor chlorinated swimming pools showed that these athletes developed early inflammatory changes in their lower airways consistent with mild asthma. Regular swimming in indoor pools increases the risk of developing asthma among adults.  

    It is likely that higher concentrations of chlorine are generated in indoor pools, compared with outdoor pools, due to inadequate ventilation of chlorine vapors.  For pool caretakers, improving ventilation and using disinfectants other than chlorine and related chemicals may prevent these health effects.

    For swimmers experiencing a chlorine sensitivity, your allergist can conduct testing to help determine the underlying cause and recommend treatment.

  • 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

    have mold allergies. Which nonprescription drugs are good to relieve headaches?

    Answer

    Many headaches can be relieved with nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen. Acetaminophen also is a good choice. Avoid using opioids to relieve headaches.

    A more important question is, what causing the headache? There are several potential causes of for headaches. I recommend you see your physician for evaluation.

    Common causes of headaches are migraine, tension and sinus headaches. Migraines are neurologic headaches. They often have an aura, such as a sense of nausea, shimmering lights, dizziness or other sensations that provide a warning that the headache is coming on. This early set of symptoms is call a prodrome.

    Tension headaches are caused by stress. There is some controversy over whether tension headaches actually exist, since many are actually migraine headaches. Tension headaches are frequently treated with NSAIDs as listed above.

    Allergies are a rare cause of headaches, though certain foods containing tyramine or phenylethylamine, such as chocolate or fermented cheeses, can induce headaches.

    Sinus headaches don’t really occur in the head. A sinus headache is usually manifested as pain over the face, particularly the cheeks and forehead. Pain in the teeth is also common with sinus headaches. If you have these symptoms, particularly if you also have yellow-green nasal drainage, congestion and postnasal drip, you should see your doctor as soon as possible.

  • Question

    Can mold on corn used to make chips like Doritos and Fritos cause severe allergic reaction?

    Answer

    Not much is known about gastrointestinal or systemic allergic reactions when inhalant allergens are ingested. There are rare case reports of adverse reactions attributed to dust mite in mite-infested flour.

    Based on pure speculation, a fungal allergen on corn would likely be broken down by the heat in the processing and baking of the product made of the corn flour. Without knowing the specifics of the mold in question, it is not possible to look up the effect of heat and processing on a particular mold.

    However, it may not be generally healthy to eat food made of flour that was subjected to the unhealthy conditions that made it become moldy. It is very likely that food made from moldy ingredients would not be very palatable either.

  • Question

    Just like there are different levels of eye doctors -- optometrist, ophthalmologist, eye surgeon, etc. -- what are the different kinds of allergy doctors, and which one would be considered the most knowledgeable?

    Answer

    Members of the specialty of Allergy/Immunology are physicians who are specifically trained to diagnose and treat patients who have asthma, allergic and immunologic diseases. Within the profession, there are certainly physicians with interest and expertise in specific areas of the field. If your allergist is certified by the American Board of Allergy and Immunology, you can be certain that he or she has completed a three-year residency program in internal medicine or pediatrics and an additional two or three years of study specifically in the field of allergy and immunology.

  • 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 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

    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.