HPV Vaccine Allergy: Gardasil 9 Yeast and the Syncope Differential
HPV vaccine allergy most often means yeast allergy, because Gardasil 9 is produced in Saccharomyces cerevisiae and a confirmed IgE-mediated yeast reaction is a formal contraindication with no alternative HPV product available in the US. The second story is adolescent vasovagal syncope, which is more common than true anaphylaxis and is frequently mislabeled. The anaphylaxis rate is roughly 1 per million doses.
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Key facts
Gardasil 9 protects against 9 HPV types covering 90% of cervical cancers; its Saccharomyces cerevisiae yeast substrate means confirmed yeast IgE allergy is the primary allergy contraindication.
Anaphylaxis after HPV vaccination occurs at approximately 1.7 cases per million doses β among the lowest rates for any licensed vaccine.
Polysorbate 80 in Gardasil formulations cross-reacts with polyethylene glycol (PEG) in some patients, an increasingly recognized cause of immediate hypersensitivity to vaccines and injectable medicines.
Fainting (vasovagal syncope) is the most common adverse event after HPV vaccination in adolescents and should not be confused with allergic anaphylaxis β it responds to lying flat, not epinephrine.
Children with egg, latex, or common food allergies do not have a contraindication to HPV vaccination β the relevant allergens are yeast, polysorbate 80, and aluminum adjuvant.
Kelso JM et al., AAAAI practice guidelines, adverse vaccine reactions
What Is HPV Vaccine Allergy?
HPV vaccine allergy is a rare IgE-mediated reaction to a component of Gardasil 9, the only HPV vaccine available in the United States since the 9-valent product replaced the earlier 4-valent Gardasil and 2-valent Cervarix.
Gardasil 9 protects against nine types of human papillomavirus β 6, 11, 16, 18, 31, 33, 45, 52, and 58 β that together cause approximately 90 percent of cervical, anal, and oropharyngeal cancers and most anogenital warts. Because HPV causes roughly 36,500 cancers per year in the US, the vaccine is one of the highest-value preventive interventions in adolescent medicine.
The clinically significant allergy concerns are twofold. First, Gardasil 9 is produced in Saccharomyces cerevisiae (baker's yeast) and contains residual yeast protein, making a documented anaphylactic reaction to yeast a formal contraindication with no alternative US product available. Second, adolescent vasovagal syncope is substantially more common than true anaphylaxis after HPV vaccination and is frequently misattributed as an allergic reaction, which is why 15-minute post-vaccination observation in a seated or lying position is explicitly recommended. The overall anaphylaxis rate is roughly 1 per million doses β consistent with the baseline vaccine anaphylaxis rate reported by McNeil and colleagues.
Symptoms of HPV Vaccine Reactions
Recognizing symptoms early helps you get the right treatment faster.
Vasovagal syncope
mildBrief pallor, diaphoresis, bradycardia, and transient loss of consciousness during or immediately after injection. Resolves within minutes in the supine position. More common than true anaphylaxis in adolescents and not an allergic reaction.
Injection-site soreness
mildLocal tenderness, redness, and mild swelling at the deltoid injection site peaking within 24 to 72 hours. An expected immune response, not allergy, and does not contraindicate future doses.
Low-grade fever and headache
mildTemperature up to 100.4Β°F, headache, and fatigue within 24 hours of injection reflect expected cytokine activation and resolve with rest and over-the-counter analgesics.
Generalized urticaria
moderateWidespread hives developing within 30 minutes of HPV injection are a hallmark of true IgE-mediated anaphylaxis, often linked to yeast or polysorbate 80 in sensitized patients, and warrant immediate epinephrine.
Angioedema
severeDeep tissue swelling of the lips, face, eyelids, or tongue after injection constitutes a serious allergic reaction; throat or tongue involvement is an airway emergency.
Bronchospasm
severeSudden wheeze, chest tightness, or shortness of breath within 30 minutes of injection can signal anaphylaxis, particularly in asthmatic patients, and requires intramuscular epinephrine.
Persistent hypotension
severeSustained low blood pressure with tachycardia after injection suggests anaphylaxis. Transient lightheadedness with bradycardia resolving supine is vasovagal syncope and does not need epinephrine.
When to see a doctor
Symptoms of HPV vaccine reactions fall into the same categories as other injected vaccines β local, systemic, vasovagal, and anaphylactic β but with one distinctive feature: vasovagal syncope is disproportionately common in the 11-to-16-year-old population that receives HPV vaccination, and it is the single largest source of misattributed 'HPV vaccine allergy.' The classic presentation of syncope is pallor, cool clammy skin, diaphoresis, bradycardia, brief loss of consciousness, and rapid recovery in the supine position within a few minutes. True IgE-mediated anaphylaxis presents with a completely different picture: generalized urticaria, angioedema, bronchospasm, persistent hypotension with tachycardia, and gastrointestinal symptoms, all developing within 5 to 30 minutes of injection. Intramuscular epinephrine into the lateral thigh is first-line treatment. The distinction matters because vasovagal syncope needs supine positioning and reassurance, while anaphylaxis needs epinephrine β confusing the two leads to under-treatment of genuine anaphylaxis or over-treatment of routine syncope. Local soreness, mild redness, and tenderness at the deltoid injection site peaking within 24 to 72 hours are expected and not allergic. Low-grade fever, headache, and fatigue in the 24 hours after injection are normal cytokine responses. Seek emergency care for any sudden wheeze, throat tightening, widespread urticaria, or sustained hypotension within 30 minutes of HPV vaccination.
HPV Vaccines and Asthma
Asthma is not a contraindication to HPV vaccination, and there is no mechanistic link between HPV vaccines and asthma flares. Patients with any severity of asthma can receive Gardasil 9 on the routine schedule with the standard 15-minute seated or supine post-vaccination observation. The aluminum adjuvant does not cross-react with common inhalant allergens. For the rare patient with polysorbate 80 hypersensitivity and concurrent asthma, allergist evaluation is appropriate before proceeding with vaccination. Any wheeze that develops within 30 minutes of injection should be treated as potential anaphylaxis with intramuscular epinephrine rather than assumed to be an asthma exacerbation β the two require different treatments.
Complications of Misdiagnosed HPV Vaccine Reactions
The dominant clinical complication of HPV vaccine reactions is misattribution: adolescents who experience vasovagal syncope are frequently labeled 'HPV allergic' and subsequently skip the remainder of the series, losing protection against nine HPV types that cause approximately 36,500 cancers per year in the US. Studies of vasovagal rates after HPV vaccination consistently show that syncope is more common than true anaphylaxis, which is why the CDC specifically recommends that adolescents remain seated or lying down for 15 minutes after the injection and be monitored for syncope rather than allergy. For patients with true yeast allergy, the lack of an alternative US HPV vaccine means that vaccination is formally contraindicated. These patients forgo HPV cancer protection unless they can be evaluated by an allergist for graded-dose administration under observation. Some academic centers with drug allergy services have successfully vaccinated yeast-allergic adolescents using a slow graded-dose protocol with premedication, but this is not a routine primary-care intervention. Delayed injection-site reactions from the aluminum adjuvant (persistent itchy nodules at the deltoid) are rare but documented and represent Type IV rather than Type I hypersensitivity. They typically resolve over months to years and are not a contraindication to subsequent doses, although affected patients may understandably prefer to skip additional HPV doses.
Series interruption from misattributed syncope
Adolescents who experience vasovagal syncope after the first or second HPV dose are often labeled 'allergic' and skip remaining doses, losing protection against 90 percent of HPV-driven cancers.
No alternative for yeast-allergic patients
Because Gardasil 9 is the only US HPV vaccine and it is produced in Saccharomyces cerevisiae, confirmed yeast anaphylaxis is a complete contraindication without a formulation alternative.
Aluminum granuloma at injection site
Rare Type IV delayed hypersensitivity reactions to the aluminum hydroxyphosphate sulfate adjuvant can produce persistent itchy nodules at the deltoid; self-resolving over months to years in most patients.
Injury from unprotected vasovagal fall
Adolescents who experience syncope while standing can sustain head injuries or fractures. Vaccinating seated or lying down, followed by 15-minute seated observation, prevents most of these injuries.
What Causes HPV Vaccine Reactions?
The culprits in a true IgE-mediated Gardasil 9 reaction are the formulation components rather than the virus-like particles themselves. Residual Saccharomyces cerevisiae yeast protein is the most clinically significant because it carries the formal contraindication language: anyone with a documented history of anaphylaxis to yeast β baker's or brewer's β should not receive Gardasil 9, and because it is the only HPV vaccine in the US, no alternative product exists. The same yeast contraindication applies to the recombinant hepatitis B vaccines (Recombivax HB, Engerix-B, Heplisav-B) produced in the same organism, making Gardasil 9 and hepatitis B vaccination the clinical pair in yeast-allergic patients.
How it works
Yeast anaphylaxis after Gardasil 9 follows the classic Type I IgE pathway: Saccharomyces cerevisiae mannoprotein-specific IgE bound to mast cell FcΞ΅RI cross-links on re-exposure to residual vaccine yeast protein and triggers mast cell degranulation with histamine, tryptase, and lipid mediator release within 5 to 30 minutes. Vasovagal syncope, by contrast, is a parasympathetic reflex with no immune involvement β venous pooling, bradycardia, and transient cerebral hypoperfusion resolve rapidly in the supine position. The delayed Type IV contact reactions sometimes seen at HPV injection sites are aluminum-driven T-cell responses rather than IgE phenomena.
Other relevant excipients include polysorbate 80, which has been documented as a rare cause of immediate hypersensitivity to multiple pharmaceuticals, with cross-reactivity to polyethylene glycol reported in 21 to 30 percent of PEG-allergic patients (Stone et al., JACI In Practice 2019). The aluminum hydroxyphosphate sulfate adjuvant used to enhance immunogenicity is a possible cause of Type IV delayed hypersensitivity (persistent itchy granulomas at the injection site) but not IgE anaphylaxis. Sodium borate, a boron-containing buffer in Gardasil 9, has no known allergy association at the doses used. The formulation contains L-histidine, NaCl, and water for injection as additional inactive ingredients.
Importantly, Gardasil 9 contains no egg, no gelatin, no neomycin, and no natural rubber latex. The injection site does not reliably cause Type IV aluminum granulomas at the rates seen with some infant vaccines, though rare cases have been reported in the Swedish and Danish literature.
Risk factors to watch for
Documented yeast anaphylaxis
A prior IgE-mediated reaction to baker's or brewer's yeast is the formal contraindication to Gardasil 9 with no alternative US HPV vaccine available. Yeast reactions in baked bread or beer are usually tolerance-predicting of vaccine reactions.
Prior hepatitis B vaccine anaphylaxis
Because both Gardasil 9 and recombinant hepatitis B vaccines are produced in the same S. cerevisiae substrate, a confirmed anaphylactic reaction to hepatitis B vaccination raises the same contraindication for HPV vaccination.
Polysorbate 80 or PEG hypersensitivity
Documented immediate hypersensitivity to polysorbate 80 or polyethylene glycol contraindicates Gardasil 9 and many other medications; evaluation by an allergist with PEG and polysorbate-specific testing is appropriate.
Adolescent age (for syncope, not true allergy)
Ages 11 to 18 have the highest rates of vasovagal syncope after any injection, which is why seated or lying-down vaccination with 15-minute observation is recommended for HPV vaccination specifically.
The Allergy Cascade
Exposure
Allergen contact
Detection
Immune recognition
IgE Response
Antibody production
Mast Cells
Histamine release
Symptoms
Allergic reaction
1.Exposure
Allergen contact
2.Detection
Immune recognition
3.IgE Response
Antibody production
4.Mast Cells
Histamine release
5.Symptoms
Allergic reaction
Diagnosing HPV Vaccine Allergy
Diagnosing a true HPV vaccine allergy begins with carefully characterizing the reaction: was it vasovagal syncope (far more common) or genuine anaphylaxis (rare)? The vasovagal pattern β pallor, bradycardia, brief loss of consciousness, rapid recovery supine β is not allergy and does not need allergist workup beyond reassurance and seated vaccination for future doses. Anaphylaxis patterns β urticaria, angioedema, bronchospasm, sustained hypotension, tachycardia β warrant formal allergist evaluation before any additional HPV doses are given. For suspected yeast allergy (the most clinically relevant culprit), specific IgE to Saccharomyces cerevisiae and to baker's yeast is available through commercial laboratories and can confirm sensitization. Skin prick testing with commercial yeast extract supplements this. Specific IgE to polysorbate 80 or polyethylene glycol can identify excipient-specific hypersensitivity when yeast testing is negative. Serum tryptase drawn 1 to 3 hours after the acute reaction, with a baseline 24 hours later, helps confirm mast cell activation retrospectively. At-home testing like Curex's 40+ environmental allergen panel (5 days, insurance accepted) can rule out comorbid environmental triggers β dust mites, molds, pet dander, pollens β in a patient with chronic respiratory symptoms misattributed to HPV vaccination, but suspected vaccine-component allergy like yeast, polysorbate 80, or PEG hypersensitivity requires allergist skin testing, specific IgE bloodwork, or graded-dose challenge. These specialized procedures are not performed at home.
Specific IgE to Saccharomyces cerevisiae
Serum IgE testing for yeast antigens is available through commercial laboratories and is the highest-yield test when the patient reports reactions to beer, bread, or prior yeast-based vaccines. A positive result supports the contraindication to Gardasil 9.
Skin prick testing with yeast extract
Allergist-administered prick testing with commercial Saccharomyces cerevisiae extract confirms clinically relevant yeast sensitization in suspected cases.
Vaccine skin prick and intradermal testing
Prick testing with Gardasil 9 followed by intradermal testing at 1:100 dilution if prick is negative is used to confirm or exclude true vaccine hypersensitivity before a repeat dose or graded-dose challenge.
Serum tryptase
Mast cell tryptase drawn 1 to 3 hours after the acute reaction and compared with a baseline sample 24 or more hours later provides biochemical evidence of anaphylaxis if elevated above 11.4 ng/mL or 20 percent plus 2 ng/mL above baseline.
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For HPV vaccine hypersensitivity specifically, the treatment hierarchy is sharply different from environmental allergy immunotherapy: vasovagal syncope is managed by positioning, suspected yeast anaphylaxis by formal contraindication and specialist referral, and true excipient allergy by formulation avoidance. Long-term desensitization in the subcutaneous or sublingual immunotherapy sense is not used for HPV vaccines because there is no chronic exposure to tolerate β the schedule is 2 or 3 doses total and protection is durable after the series. The drug-allergy version of 'desensitization' for HPV vaccination is a one-time graded-dose challenge performed by an allergist in selected yeast-allergic patients who have a strong indication for HPV cancer protection. Published case series suggest this can be done safely with antihistamine premedication and extended observation, but it is not a routine intervention and should only happen at specialized centers. Curex sublingual immunotherapy drops ($39/month) treat IgE-mediated environmental allergies β dust mites, pollens, pet dander, molds β not vaccine-component allergy. HPV vaccine hypersensitivity evaluation is handled by allergists via skin testing, yeast-specific IgE bloodwork, and graded-dose challenge in selected cases, not by sublingual immunotherapy. If an adolescent has comorbid environmental allergies that are driving chronic respiratory symptoms mistakenly blamed on HPV vaccination, the at-home environmental panel and SLIT pathway can address those separately.
Clinical history and reaction characterization
Distinguish vasovagal syncope from true anaphylaxis based on timing, skin findings, heart rate, and blood pressure. Syncope does not need allergist workup; anaphylaxis does.
Yeast and excipient IgE testing
When anaphylaxis is suspected, specific IgE to Saccharomyces cerevisiae and skin prick testing with yeast extract are the highest-yield diagnostic tests. Polysorbate 80 and PEG testing for completeness.
Confirmation and contraindication
Confirmed yeast anaphylaxis results in a formal contraindication to Gardasil 9 (and recombinant hepatitis B vaccines), which is documented on the problem list with acceptable alternative preventive strategies.
Specialist graded-dose option
Selected patients with strong indications can be referred to a drug allergy center for graded-dose administration with premedication and extended observation; success rates vary by center and are not standardized.
βMost patients labeled 'HPV vaccine allergic' actually experienced vasovagal syncope and can safely continue the series seated or lying down; true yeast anaphylaxis is rare but does carry a firm contraindicationβ
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Living With an HPV Vaccine Reaction Label
Living with a label of 'HPV vaccine allergy' depends entirely on what the reaction really was. For the overwhelming majority of adolescents whose label came from a vasovagal syncope episode, the practical reality is that the label is inaccurate and the remainder of the series can and should be completed with seated or lying-down administration. A brief conversation with a pediatrician or allergist can usually clarify the distinction and restart the schedule. For the small minority with confirmed yeast anaphylaxis, living with the label means understanding that Gardasil 9 is contraindicated, that recombinant hepatitis B vaccines share the same concern, and that alternative HPV cancer protection is not available outside of specialized drug allergy centers. These patients should discuss HPV exposure reduction strategies and cervical cancer screening more frequently with their primary care provider.
Syncope recovery and series completion
If a prior HPV dose was followed by brief fainting with rapid recovery, that is vasovagal syncope and not allergy. Future doses should be given seated or lying down with 15-minute post-vaccination observation, and the series should be completed on schedule.
Yeast allergy and HPV vaccination
Confirmed IgE-mediated anaphylaxis to yeast contraindicates Gardasil 9, and because it is the only HPV vaccine in the US, no alternative product is available. Specialized drug allergy centers can consider graded-dose administration on a case-by-case basis.
Hepatitis B parallel
Because both Gardasil 9 and recombinant hepatitis B vaccines are produced in Saccharomyces cerevisiae, a confirmed yeast allergy typically rules out both products. This needs coordinated planning across the full immunization schedule.
Alternative cancer screening for yeast-allergic patients
Patients who cannot receive HPV vaccination should discuss enhanced cervical cancer screening (Pap and HPV testing) and safer sex counseling with their primary care provider as partial mitigation of residual HPV cancer risk.
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Prevention Tips
Vaccinate seated or lying down
Adolescents should receive HPV vaccination seated or lying down and remain in that position for the 15-minute observation period to prevent injury from vasovagal syncope.
Screen for yeast allergy before the first dose
Ask about reactions to baker's yeast, brewer's yeast, beer, bread, and prior recombinant hepatitis B vaccination; confirmed yeast anaphylaxis is a contraindication to Gardasil 9.
Stay for the 15-minute observation
Every adolescent should remain at the vaccinating site for 15 minutes so that vasovagal syncope or, rarely, anaphylaxis can be recognized and managed promptly.
Complete the series despite vasovagal syncope
Vasovagal syncope is not an allergy and is not a contraindication to future doses; adolescents should complete the 2- or 3-dose schedule with appropriate positioning.
Document true contraindications clearly
Confirmed yeast anaphylaxis should be documented on the problem list along with its implications for Gardasil 9 and recombinant hepatitis B vaccination so that future clinicians understand the restriction.
Long-term Outlook
The long-term outlook for most patients labeled 'HPV vaccine allergic' is excellent, because most such labels actually reflect vasovagal syncope and the series can be safely completed with appropriate positioning. For the small number with genuine yeast anaphylaxis, the prognosis is driven by the loss of HPV cancer protection rather than by any immediate vaccine risk, and mitigation strategies include enhanced cervical cancer screening, safer sex counseling, and, in selected patients, specialist-supervised graded-dose administration. The public health stakes are substantial: HPV causes roughly 36,500 cancers per year in the US, and Gardasil 9 protects against the nine types responsible for approximately 90 percent of those cancers. Clearing inappropriate labels and completing the series remains one of the highest-value preventive interventions in adolescent medicine.
Key takeaways
Vasovagal syncope is more common than true anaphylaxis after HPV vaccination and is not an allergy
Gardasil 9 is produced in Saccharomyces cerevisiae β confirmed yeast anaphylaxis is a formal contraindication
No alternative HPV vaccine is available in the US, so yeast-allergic patients need specialist referral
Adolescents should be vaccinated seated or lying down with 15-minute observation to prevent injury
HPV protects against roughly 90 percent of cervical, anal, and oropharyngeal cancers β completing the series matters
Diet and HPV Vaccination
For most patients, diet plays no role in HPV vaccination. The one exception is yeast: patients who experience anaphylaxis to baker's yeast in bread, brewer's yeast in beer, or nutritional yeast in foods may be at genuinely elevated risk for Gardasil 9 reactions and should be evaluated by an allergist before vaccination. Tolerating yeast in baked or brewed foods generally predicts tolerance of the trace amounts in the vaccine, but specific IgE testing is warranted when the dietary history suggests true anaphylaxis.
Foods to limit
Baker's yeast (in confirmed yeast anaphylaxis)
Shares Saccharomyces cerevisiae antigens with Gardasil 9 residual yeast protein; confirmed anaphylaxis to yeast contraindicates vaccination.
Brewer's yeast (in confirmed yeast anaphylaxis)
Same species as baker's yeast; confirmed anaphylaxis to beer containing S. cerevisiae is clinically equivalent for contraindication purposes.
The HPV vaccine's allergy risk is small but specific: yeast IgE allergy warrants allergist consultation, and polysorbate 80 cross-reactivity with PEG should be considered after reactions to other polysorbate injectables. Common food allergies are not a contraindication. Most patients with historical 'allergies' can receive the vaccine safely with standard observation.
Frequently Asked Questions
No. Brief fainting with pallor, clamminess, and rapid recovery after an HPV shot is vasovagal syncope β a parasympathetic reflex triggered by the injection, not an IgE-mediated allergic reaction. Vasovagal syncope is particularly common in adolescents receiving HPV vaccination and is the single most frequent adverse event. True anaphylaxis is rare (roughly 1 per million doses) and presents differently, with flushing, hives, wheezing, persistent hypotension, and tachycardia developing within 5 to 30 minutes. Syncope is not a contraindication to completing the HPV series.
Only after allergist evaluation. Gardasil 9, the only HPV vaccine in the US, is produced in Saccharomyces cerevisiae (baker's yeast) and contains residual yeast protein, so a documented IgE-mediated anaphylaxis to yeast is a formal contraindication. However, many patients who describe themselves as 'yeast intolerant' or have mild symptoms after beer do not have true IgE-mediated anaphylaxis, and specific IgE testing plus skin prick testing with yeast extract can clarify whether the contraindication truly applies. For patients with confirmed yeast anaphylaxis, some academic drug-allergy centers can offer graded-dose administration under observation, but this is not a routine primary-care intervention.
Gardasil was the original 4-valent HPV vaccine covering HPV types 6, 11, 16, and 18. Gardasil 9 is the 9-valent successor covering types 6, 11, 16, 18, 31, 33, 45, 52, and 58 β adding protection against five additional cancer-causing types. Cervarix was a 2-valent product covering types 16 and 18 only. Both Gardasil and Cervarix have been discontinued in the US, so Gardasil 9 is the only HPV vaccine currently available. The three products differed in some excipients and serotype coverage, but all were produced in Saccharomyces cerevisiae and carried the same yeast contraindication.
All HPV vaccine recipients should remain at the vaccinating site for 15 minutes after injection. This observation period covers the window during which true IgE-mediated anaphylaxis is most likely to appear (typically 5 to 30 minutes after injection) and also covers vasovagal syncope, which most commonly occurs within the first few minutes. Some adolescents benefit from remaining seated for slightly longer if they have a prior history of fainting with injections. Delayed reactions, including serum sickness-like illness, can appear 1 to 3 weeks later but are not the focus of the mandatory observation period.
Large post-licensure surveillance studies β from the CDC Vaccine Safety Datalink, the European Medicines Agency, and national registries in Denmark, Sweden, and the UK β have not identified an increased rate of postural orthostatic tachycardia syndrome (POTS), chronic fatigue, autoimmune disease, or complex regional pain syndrome attributable to HPV vaccination. Individual case reports and social media claims have occasionally linked these conditions to HPV vaccines, but controlled population-level data do not support a causal relationship. The Global Advisory Committee on Vaccine Safety has repeatedly affirmed the safety profile of HPV vaccination.
Possibly, depending on what the reaction was. Both Gardasil 9 and the recombinant hepatitis B vaccines (Recombivax HB, Engerix-B, Heplisav-B) are produced in Saccharomyces cerevisiae and share the same yeast concern. A documented anaphylactic reaction to recombinant hepatitis B vaccination in an adolescent or young adult is an important signal that HPV vaccination should be preceded by yeast-specific IgE testing and allergist evaluation. Local soreness or vasovagal syncope after hepatitis B vaccination does not predict HPV vaccine allergy and is not a contraindication to HPV vaccination.
Gardasil 9 contains polysorbate 80 as an excipient, so a confirmed IgE-mediated allergy to polysorbate 80 is a contraindication that should prompt allergist evaluation before vaccination. Polysorbate 80 hypersensitivity is uncommon but has been documented with a range of medications and shares cross-reactivity with polyethylene glycol in 21 to 30 percent of PEG-allergic patients. Because Gardasil 9 is the only HPV vaccine available in the US, polysorbate 80βallergic patients face the same no-alternative situation as yeast-allergic patients, and specialist referral for graded-dose administration is appropriate when vaccination is strongly indicated.
Medical References
- [1]Meites E, Szilagyi PG, Chesson HW, et al. Human Papillomavirus Vaccination for Adults: Updated Recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep 2019;68(32):698β702.
- [2]McNeil MM, Weintraub ES, Duffy J, et al. Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol 2016;137(3):868β878.
- [3]Kelso JM, Greenhawt MJ, Li JT, et al. Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol 2012;130(1):25β43.
- [4]Stone CA Jr, Liu Y, Relling MV, et al. Immediate Hypersensitivity to Polyethylene Glycols and Polysorbates: More Common Than We Have Recognized. J Allergy Clin Immunol Pract 2019;7(5):1533β1540.
- [5]CDC Pink Book β Epidemiology and Prevention of Vaccine-Preventable Diseases, 14th ed., Human Papillomavirus chapter. 2021.
- [6]Arana JE, Harrington T, Cano M, et al. Post-licensure safety monitoring of quadrivalent human papillomavirus vaccine in the Vaccine Adverse Event Reporting System (VAERS), 2009β2015. Vaccine 2018;36(13):1781β1788.
- [7]Wood RA, Berger M, Dreskin SC, et al. An algorithm for treatment of patients with hypersensitivity reactions after vaccines. Pediatrics 2008;122(3):e771β777.
This content is for informational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about a medical condition. Content reviewed by board-certified allergists at Curex.
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