Study, Vaccines

Hypotension

Wheezing

Upper Airway Obstruction

Other

Epinephrine

Analphylaxis

Bilyk and Dubchik, 1978: tetanus

Yes

Dyspnea, "tightness" in chest

No

Better in hours

Yes

Yes

Mansfield et al., 1986: rick skin test: tetanus

Yes

Yes

No

Urticaria 7 yr ago after tetanus + antitoxin

Yes

Yes

Ovens. 1986: diphtheria; tetanus; polio

Yes

Yes

Yes

Resolved

Yes

Yes

Mandal, 1980; tetanus

?

No

Yes

Resolved in 12 h with antihistamines, dexamethasone

No

Yes

Werne and Garrow,a,b 1946: diphtheria; pertussis

Probable

No

Yes

Death/autopsy: arterial narrowing and infiltration with polymorpho nuclear leukocytes. eosinophils; brain, lungs, liver

No

Yes

Werne and Garrow.a,b 1946; diphtheria; pertussis

Probable

No

Yes

Same

No

Yes

Table 5-1. One of the 13 cases of anaphylaxis from 1933 was described in a review by Regamey (1965). Three occurred in 1940 and were presumed (by skin testing) to be related to contamination of the vaccine by Witte peptones (Parish and Oakley, 1940; Whittingham, 1940). Two deaths occurred in association with tetanus toxoid administered as a single antigen. In the 1965 review, Regamey reported a fatality in a 20-year-old man 2 hours after he received his third tetanus toxoid injection. This patient had a history of an episode of collapse and convulsions after receiving his second dose of tetanus toxoid. In 1973, Staak and Wirth reported the death of a 24-year-old woman 30 minutes after receiving an injection of tetanus toxoid.



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