Meningococcal Vaccine Allergy: Carrier Protein & 5-Product Decision Map
Meningococcal vaccine allergy is uncommon but genuinely complex because the five US products โ Menactra, Menveo, MenQuadfi, Bexsero, Trumenba โ have five distinct excipient profiles. Menactra uses diphtheria toxoid with a latex vial stopper, Menveo uses CRM197, MenQuadfi uses tetanus toxoid, Bexsero contains kanamycin and latex tip caps, and Trumenba uses polysorbate 80. Matching carrier protein and latex status to the individual patient is the entire clinical task.
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Key facts
The 5 US meningococcal vaccines (Menactra, Menveo, MenQuadfi, Bexsero, Trumenba) have 5 distinct excipient profiles โ carrier protein and latex status must be matched to each patient's specific allergy history.
Menactra contains a latex vial stopper and uses diphtheria toxoid as carrier; latex-allergic patients must switch to MenQuadfi (tetanus toxoid, latex-free) or Menveo (CRM197, latex-free).
CDC Pink Book, 14th ed., Meningococcal Disease chapter, 2021
Trumenba (serogroup B) contains polysorbate 80 โ patients with a history of polysorbate 80 hypersensitivity require careful pre-vaccination evaluation before receiving this product.
True anaphylaxis to meningococcal vaccine occurs in fewer than 1 per million doses โ the overwhelming majority of reported reactions are vasovagal syncope or anxiety-related.
EAACI guidelines recommend a 15โ30 minute observation period after all vaccines for patients with documented allergy history, with epinephrine immediately available for the rare systemic reaction.
What Is Meningococcal Vaccine Allergy?
Meningococcal vaccine allergy is a rare IgE-mediated reaction to a component of one of the five licensed US meningococcal vaccines, and it is the most complicated vaccine allergy in the adult immunization schedule because each of the five products has a different excipient profile.
Menactra uses diphtheria toxoid as its carrier protein and has natural rubber latex in the vial stopper. Menveo uses the genetically detoxified diphtheria derivative CRM197 and has no latex. MenQuadfi uses tetanus toxoid as its carrier, making it contraindicated for patients with tetanus anaphylaxis. Bexsero (serogroup B) contains residual kanamycin from the manufacturing process and natural rubber latex in the syringe tip caps. Trumenba (serogroup B) uses polysorbate 80 and has no latex.
Because of these differences, the question 'Can I get a meningococcal vaccine?' almost always reduces to 'Which one?' โ and the answer depends on the patient's specific carrier protein, antibiotic, and latex history. No single meningococcal product is a universal safe default, and patients with multiple excipient concerns sometimes need allergist review to identify the compatible option. The ACIP 2024 routine schedule gives MenACWY at 11โ12 years with a booster at 16, and MenB under shared clinical decision-making at 16โ23 years.
Symptoms of Meningococcal Vaccine Reactions
Recognizing symptoms early helps you get the right treatment faster.
Local injection-site soreness
mildTenderness, redness, and swelling at the deltoid injection site peaking within 24 to 72 hours; prominent after Bexsero which is the most reactogenic meningococcal product. This is a normal immune response, not allergy.
Low-grade fever and myalgia
mildTemperature up to 100.4ยฐF, body aches, and fatigue within 48 hours, especially after Bexsero. Expected cytokine response that resolves with rest and over-the-counter analgesics.
Vasovagal syncope
mildBrief pallor, diaphoresis, bradycardia, and transient loss of consciousness during or immediately after injection, most common in adolescents. Resolves within minutes supine; not allergic and not a contraindication to future doses.
Generalized urticaria
moderateWidespread hives developing within 30 minutes of injection are a hallmark of true IgE-mediated anaphylaxis and require immediate epinephrine and further evaluation.
Angioedema
severeDeep tissue swelling of the lips, face, or tongue after meningococcal injection constitutes a serious allergic reaction; throat or tongue involvement is an airway emergency.
Bronchospasm and wheeze
severeSudden wheezing, chest tightness, or shortness of breath within 30 minutes of injection can signal anaphylaxis, especially in patients with underlying asthma.
Persistent hypotension
severeSustained low blood pressure with tachycardia after injection suggests anaphylaxis. Transient lightheadedness with bradycardia that resolves supine is vasovagal syncope and is not treated with epinephrine.
Latex-mediated anaphylaxis
severeIn latex-allergic patients, contact with the Menactra vial stopper or Bexsero syringe tip cap can trigger anaphylaxis; the latex-free Menveo, MenQuadfi, and Trumenba are preferred alternatives.
When to see a doctor
Symptoms of meningococcal vaccine reactions span the same categories as other vaccines โ local injection-site reactions, expected systemic cytokine response, vasovagal syncope, and rare true anaphylaxis โ but with some product-specific nuances worth knowing. Bexsero is the most reactogenic of the meningococcal products, with a high rate of local pain, swelling, fever, and myalgia in the 24 to 48 hours after injection. This is not an allergy but is frequently reported as one. True IgE-mediated anaphylaxis presents within 5 to 30 minutes of injection with urticaria, angioedema, bronchospasm, hypotension, or gastrointestinal symptoms and requires immediate intramuscular epinephrine. The 15-minute post-vaccination observation period is mandatory for every meningococcal dose. Vasovagal syncope is particularly common in adolescents and is the largest single source of misattributed 'meningococcal allergy' โ the classic presentation is brief pallor, diaphoresis, bradycardia, and rapid recovery in the supine position. Latex-mediated anaphylaxis in spina bifida or multiply-exposed patients can occur specifically with Menactra (vial stopper) or Bexsero (syringe tip cap) if the latex is contacted during preparation. Kanamycin allergy from Bexsero is also theoretical but documented. Seek emergency care for any sudden wheeze, throat tightening, widespread hives, or hypotension within 30 minutes of any injection.
Meningococcal Vaccines and Asthma
Asthma is not a contraindication to any meningococcal vaccine, and there is no evidence that these vaccines trigger asthma flares at rates above baseline for any adolescent immunization. Patients with well-controlled asthma of any severity can receive MenACWY and MenB on the routine schedule with standard 15-minute observation. Bexsero is the most reactogenic of the meningococcal products and may produce mild transient malaise that some asthmatic patients experience as a vague 'flare' in the 24 to 48 hours after injection, but this is not bronchospasm and does not predict future reactions. For the rare patient with polysorbate 80 hypersensitivity and asthma, Trumenba should be avoided in favor of Bexsero, provided kanamycin and latex history are clear. Patients with severe, poorly controlled asthma who experience any wheeze during the 15-minute observation period should be assessed promptly and treated with bronchodilators or epinephrine as clinically indicated.
Complications of Misdiagnosed Meningococcal Allergy
The main clinical complication of an inappropriate meningococcal allergy label is under-vaccination of a patient who remains at ongoing risk for invasive meningococcal disease โ a condition with roughly 10 to 15 percent case-fatality even with modern antibiotic treatment and long-term neurological sequelae in survivors. College freshmen in residence halls, patients with complement deficiencies, asplenic patients, and travelers to the meningitis belt all face meaningful exposure risk that proper vaccination mitigates. A second complication is cascading product avoidance: a patient labeled 'allergic to meningococcal vaccine' after an adolescent vasovagal episode may subsequently be denied all five products despite being fully eligible for at least four of them. The 5-product decision matrix exists precisely so that patients with one specific contraindication can receive a compatible alternative, but only if the specific contraindication is accurately identified. In patients with confirmed latex allergy, accidental exposure to the Menactra vial stopper or Bexsero syringe tip cap during preparation can provoke anaphylaxis, which is why latex-free Menveo, MenQuadfi, and Trumenba are strongly preferred for this population. In patients on eculizumab for paroxysmal nocturnal hemoglobinuria or atypical hemolytic uremic syndrome, meningococcal disease risk is especially high and vaccination compliance is critical regardless of mild reaction history.
Under-vaccination against invasive meningococcal disease
Missing routine or booster meningococcal doses leaves adolescents and high-risk adults vulnerable to a pathogen with 10 to 15 percent case-fatality and long-term neurological sequelae in survivors.
Cascading 5-product avoidance
A vague 'meningococcal allergy' label can trigger avoidance of all five products when proper allergist evaluation would identify at least one compatible option in most patients.
Latex anaphylaxis in high-risk populations
Patients with spina bifida or multiple surgical exposures are at particularly high risk of latex anaphylaxis from Menactra vials or Bexsero tip caps; latex-free alternatives are essential.
Interchangeability errors with MenB
Bexsero and Trumenba are not interchangeable โ starting a series with one product and switching to the other invalidates the completed series and exposes the patient to unnecessary additional doses.
What Causes Meningococcal Vaccine Reactions?
Reactions to meningococcal vaccines are almost always caused by a specific formulation component rather than the meningococcal polysaccharide or outer membrane vesicles themselves. The MenACWY conjugate products (Menactra, Menveo, MenQuadfi) all attach capsular polysaccharides from Neisseria meningitidis serogroups A, C, W, and Y to a carrier protein that drives robust T-cell-dependent immunity. The choice of carrier is where the cross-contraindication stories begin: diphtheria toxoid in Menactra, CRM197 (a non-toxic diphtheria mutant) in Menveo, tetanus toxoid in MenQuadfi.
How it works
True anaphylaxis to meningococcal vaccines follows the classic Type I hypersensitivity pathway, with vaccine-component-specific IgE bound to mast cell FcฮตRI cross-linking on re-exposure and releasing histamine, tryptase, and lipid mediators within minutes. The distinctive mechanistic story here is carrier-protein cross-reactivity: diphtheria toxoid IgE and CRM197 share epitopes, so a reaction to Menactra or a DTaP dose can predict a reaction to Menveo or a Prevnar conjugate, and tetanus toxoid IgE predicts a reaction to MenQuadfi specifically. Latex reactions are a separate IgE-mediated pathway directed at Hevea brasiliensis proteins in the vial stopper or syringe tip cap.
Serogroup B vaccines are a different class entirely. Bexsero is a 4CMenB product containing factor H binding protein (fHbp), Neisserial adhesin A (NadA), Neisserial heparin binding antigen (NHBA), and PorA outer membrane vesicles. It retains residual kanamycin from the manufacturing cell substrate at trace levels, and its syringe tip caps contain natural rubber latex. Trumenba is a bivalent factor H binding protein vaccine with polysorbate 80 as a stabilizer and no latex components. Critically, Bexsero and Trumenba are not interchangeable โ a patient who starts one series must complete all doses with the same product, even if an allergy to the first product is later identified.
Additional concerns specific to meningococcal vaccination include latex allergy in patients with spina bifida (a population that receives multiple meningococcal doses because of asplenia or complement deficiency), kanamycin hypersensitivity in patients with prior aminoglycoside allergy, and polysorbate 80 hypersensitivity. No meningococcal vaccine contains egg, gelatin, or yeast.
Risk factors to watch for
Spina bifida or multiple surgeries
Patients with spina bifida, chronic catheterization, or multiple surgical exposures have markedly elevated rates of natural rubber latex allergy and should avoid Menactra vials and Bexsero tip caps.
Prior diphtheria or tetanus toxoid anaphylaxis
A documented reaction to DTaP, Tdap, or DT routes the patient away from Menactra (DT carrier), Menveo (CRM197), or MenQuadfi (TT carrier) depending on which toxoid was implicated.
Aminoglycoside antibiotic allergy
Prior anaphylaxis to kanamycin, neomycin, gentamicin, or streptomycin is a relative contraindication to Bexsero, which contains residual kanamycin from its manufacturing process.
Polysorbate 80 or PEG hypersensitivity
Confirmed immediate hypersensitivity to polysorbate 80 contraindicates Trumenba; polyethylene glycol cross-reactivity is reported in 21 to 30 percent of PEG-allergic patients.
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 Meningococcal Vaccine Allergy
Confirming meningococcal vaccine allergy requires allergist evaluation with a structured history, skin testing with the suspect product, and, where appropriate, specific IgE bloodwork or graded-dose challenge. The first step is always a careful review of exactly which product was given, what excipients it contained, and what the reaction actually looked like. Vasovagal syncope in an adolescent is not allergy; a brisk reaction to the most reactogenic product Bexsero is usually not allergy either; persistent urticaria, angioedema, or bronchospasm within 30 minutes is. Because the 5-product matrix creates such specific cross-contraindication chains, identifying the exact culprit component has high practical value. A patient with prior diphtheria toxoid anaphylaxis can still receive MenQuadfi (TT carrier) or Trumenba (no carrier) even though Menactra, Menveo, and Bexsero are contraindicated for them. A patient with tetanus toxoid anaphylaxis can receive Menactra, Menveo, or Bexsero. A latex-allergic patient can receive any of the three latex-free products. Skin testing with diphtheria and tetanus toxoids, plus latex-specific IgE, often clarifies the picture entirely. At-home testing like Curex's 40+ environmental allergen panel (5 days, insurance accepted) can rule out comorbid environmental triggers in a patient with chronic respiratory symptoms mistakenly linked to meningococcal vaccination, but suspected vaccine-component allergy โ diphtheria toxoid, tetanus toxoid, CRM197, kanamycin, polysorbate 80, or latex โ requires allergist skin testing, specific IgE bloodwork, or graded-dose challenge. These procedures cannot be performed at home.
Vaccine skin prick and intradermal testing
Allergist-administered prick testing with the suspect meningococcal vaccine, followed by intradermal testing at 1:100 dilution if prick is negative. Used to confirm or exclude true hypersensitivity before a repeat dose or an alternative product.
Toxoid skin testing (diphtheria and tetanus)
Intradermal testing with dilute diphtheria or tetanus toxoid clarifies carrier-protein cross-reactivity and identifies which meningococcal products are safe. A negative diphtheria test typically permits Menactra, Menveo, and Bexsero.
Latex-specific IgE
Serum IgE to Hevea brasiliensis proteins identifies latex-allergic patients who must avoid the Menactra vial stopper and the Bexsero syringe tip cap. Particularly important in spina bifida and multiply-operated populations.
Graded-dose challenge
Under allergist supervision, the suspect vaccine is administered in two or three incremental doses with observation between steps. Reserved for patients who need a specific product and have equivocal testing.
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The long-term solution to allergies
Instead of masking symptoms, immunotherapy retrains your immune system.
For meningococcal vaccine hypersensitivity, the treatment pathway is product substitution followed by graded-dose administration when clinically needed โ not long-term desensitization. The AAAAI vaccine allergy practice parameter outlines a two- or three-step protocol for administering a vaccine to a patient with equivocal skin testing who genuinely needs protection, with observation between each step and intramuscular epinephrine immediately available. Desensitization in the drug-allergy sense (building tolerance through incrementally larger doses over hours) is rarely needed because the 5-product matrix usually identifies a safe alternative product. For patients with confirmed carrier-protein cross-reactivity, the contraindication persists for life and applies to multiple vaccine families: a diphtheria toxoid allergy rules out Menactra and Menveo (CRM197) and most Prevnar conjugates, while a tetanus toxoid allergy rules out MenQuadfi and Adacel-style tetanus boosters. A consolidated allergist visit can map these contraindications across the entire adult immunization schedule in one session. Curex sublingual immunotherapy drops ($39/month) treat IgE-mediated environmental allergies โ dust mites, pollens, pet dander, molds โ not vaccine-component allergy. Meningococcal vaccine hypersensitivity is managed by allergists through the 5-product substitution logic, skin testing, latex-specific IgE, and, when needed, graded-dose challenge under observation. Sublingual immunotherapy does not desensitize latex allergy, carrier-protein allergy, or aminoglycoside allergy.
Clinical history and product identification
Confirm exactly which of the five products was given, exactly what symptoms occurred, and exactly when. Most 'meningococcal allergies' turn out to be vasovagal episodes or expected Bexsero reactogenicity.
Targeted testing (toxoids, latex, polysorbate)
Skin testing with diphtheria toxoid, tetanus toxoid, latex-specific IgE, and polysorbate 80 testing when indicated maps the 5-product matrix to the individual patient.
Product substitution
Pick the meningococcal product compatible with the identified contraindications: MenQuadfi for diphtheria allergy, Menveo for tetanus allergy, a latex-free product for latex allergy, Bexsero for polysorbate 80 allergy, Trumenba for kanamycin allergy.
Graded-dose challenge if no alternative exists
When every compatible product is somehow contraindicated, two- or three-step graded-dose administration under observation enables safe vaccination for patients with genuine exposure risk.
โMost patients labeled 'meningococcal allergic' can be safely vaccinated with at least one of the five products after appropriate evaluationโ
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Living With Meningococcal Vaccine Allergy
Living with a meningococcal vaccine allergy label is mostly about knowing which specific excipient or carrier protein is contraindicated and which of the five US products is appropriate for you. For most patients, the impact on daily life is limited to clear communication at vaccination visits and a short note on the medical problem list. The practical inconvenience is highest for patients with multiple overlapping contraindications โ for example, a spina bifida patient with both latex and aminoglycoside concerns who must navigate the full 5-product matrix with an allergist. For adolescents entering college or the military, confirming meningococcal vaccination status and any product-specific contraindications is a routine part of institutional health screening. Travelers to the meningitis belt of sub-Saharan Africa or to the Hajj pilgrimage face a formal yellow card requirement for MenACWY vaccination, which must be completed at least 10 days before entry. Patients with complement deficiencies or asplenia, including those on eculizumab, require particularly rigorous adherence to the meningococcal schedule because their baseline risk of invasive disease is dramatically elevated.
At the vaccination visit
Bring a current list of documented contraindications and tolerated products. Ask the vaccinating clinician to confirm the specific product being drawn โ Menactra, Menveo, MenQuadfi, Bexsero, or Trumenba โ and to verify compatibility with your allergy profile.
College and travel requirements
MenACWY vaccination is routinely required for college entry (especially residence halls) and for Hajj pilgrimage entry. Travel medicine clinics issue the formal documentation needed for international certification.
Starting and finishing a MenB series
Once you begin a MenB series with either Bexsero or Trumenba, every subsequent dose must use the same product. Confirm product availability at your clinic before starting so you can complete the series without interruption.
High-risk populations
Patients with complement deficiencies, asplenia, or on eculizumab face particularly high baseline risk of invasive meningococcal disease and should complete the schedule with especially close attention to the product matrix.
Seasonal Patterns
January - December
medium intensity
Prevention Tips
Match the product to the allergy profile
The 5-product matrix means there is almost always an acceptable choice: MenQuadfi for diphtheria allergy, Menveo for tetanus allergy, latex-free products for latex allergy, Bexsero for polysorbate 80 allergy, Trumenba for kanamycin allergy.
Confirm MenB product before first dose
Bexsero and Trumenba are not interchangeable, so confirm the chosen MenB product before administering the first dose of a 2- or 3-dose series.
Flag latex allergy early
Patients with spina bifida, multiple surgeries, or documented latex allergy should receive latex-free Menveo, MenQuadfi, or Trumenba exclusively โ never Menactra vials or Bexsero tip caps.
Observe for 15 minutes after every dose
All meningococcal vaccine recipients should remain seated or lying down for 15 minutes after injection to minimize injury from vasovagal syncope and to allow immediate response to any acute reaction.
Document contraindications across the schedule
Carrier-protein allergies affect multiple vaccine families beyond meningococcal; a consolidated problem-list entry prevents cascading errors across pneumococcal, Hib, and Tdap scheduling.
Long-term Outlook
The long-term prognosis for patients labeled with a meningococcal vaccine allergy is generally excellent, because the 5-product matrix usually provides at least one compatible alternative after proper allergist evaluation. Cross-reactivity to carrier proteins (diphtheria or tetanus toxoid) is durable rather than transient, but it typically affects only some products in the matrix, not all five. Latex allergy and polysorbate 80 hypersensitivity likewise rule out specific products rather than the whole class. The clinical stakes remain meaningful because invasive meningococcal disease carries roughly 10 to 15 percent case-fatality even with prompt treatment and leaves long-term neurological or limb sequelae in many survivors. Matching the right product to the right patient, rather than imposing blanket avoidance, is the highest-value preventive step for adolescents, travelers, and high-risk adults.
Key takeaways
Five US products โ Menactra, Menveo, MenQuadfi, Bexsero, Trumenba โ have five distinct excipient profiles
Menactra uses diphtheria toxoid and a latex vial stopper; Menveo uses CRM197; MenQuadfi uses tetanus toxoid
Bexsero contains kanamycin and latex tip caps; Trumenba uses polysorbate 80 and has no latex
Bexsero and Trumenba are not interchangeable โ complete the series with the same product
Proper allergist evaluation almost always identifies a compatible product for patients with a single contraindication
Meningococcal vaccine allergy workup is really an excipient allergy workup โ you need to know which carrier protein, whether there's latex rubber in the stopper or tip cap, and whether the patient has polysorbate 80 sensitivity before you select a product; the 5-product matrix makes product substitution straightforward once you have that information.
Frequently Asked Questions
Avoid Menactra, because its vial stopper contains natural rubber latex, and Bexsero, because its syringe tip caps contain natural rubber latex. The latex-free meningococcal options are Menveo and MenQuadfi for serogroups A, C, W, and Y coverage, and Trumenba for serogroup B coverage. Latex allergy is particularly important to flag for patients with spina bifida or a history of multiple surgeries, since latex sensitization rates are dramatically elevated in these populations. Ask the vaccinating clinician to confirm the specific product being drawn before administration and keep latex-free products on the problem list for future reference.
All three are MenACWY conjugate vaccines that cover serogroups A, C, W, and Y, but they differ in their carrier protein. Menactra uses diphtheria toxoid and has a latex vial stopper. Menveo uses CRM197, a non-toxic mutant of diphtheria toxin, and has no latex. MenQuadfi uses tetanus toxoid as its carrier and has no latex. Immunogenicity is comparable across all three against the covered serogroups. The choice between them is driven primarily by allergy history: patients with diphtheria toxoid anaphylaxis need MenQuadfi, patients with tetanus toxoid anaphylaxis need Menactra or Menveo, and patients with latex allergy need Menveo or MenQuadfi.
No โ Bexsero and Trumenba are not interchangeable, and the ACIP specifically recommends completing the MenB series with the same product you started. The two vaccines use different antigens (Bexsero contains four MenB components including factor H binding protein, NadA, NHBA, and PorA; Trumenba is a bivalent factor H binding protein vaccine) and their protection is not cumulative. If you develop a reaction mid-series, the pragmatic options are to continue the current product under graded-dose administration, to restart a new complete series with the alternative product, or to forgo MenB coverage after weighing your individual exposure risk with your clinician.
No. None of the five currently licensed US meningococcal vaccines โ Menactra, Menveo, MenQuadfi, Bexsero, or Trumenba โ contains egg protein, gelatin, yeast, or porcine or bovine components. This makes them a relatively clean option for patients with food allergies or gelatin hypersensitivity. The excipients that do matter for allergy are the carrier proteins (diphtheria toxoid, CRM197, or tetanus toxoid), residual kanamycin (Bexsero only), polysorbate 80 (Trumenba only), and natural rubber latex (Menactra vial stopper and Bexsero syringe tip cap).
Anaphylaxis to meningococcal vaccines is rare. The CDC Vaccine Safety Datalink study by McNeil and colleagues reported an overall vaccine anaphylaxis rate of 1.31 cases per million doses across all vaccines studied, and meningococcal-specific rates are consistent with that baseline. The majority of reported meningococcal vaccine 'reactions' turn out to be vasovagal syncope in adolescents, brisk local inflammation after Bexsero (the most reactogenic of the five products), or expected low-grade fever and myalgia. True IgE-mediated anaphylaxis develops within 5 to 30 minutes of injection and requires immediate intramuscular epinephrine.
Bexsero is a multi-component recombinant vaccine containing factor H binding protein, Neisserial adhesin A, NHBA, and PorA outer membrane vesicles in an aluminum hydroxide adjuvant. This broad antigen profile and the adjuvant combine to produce a vigorous local immune response that frequently causes injection-site pain, redness, swelling, and low-grade fever in the 24 to 48 hours after vaccination. These symptoms are expected rather than allergic, and they reflect the immunogenicity that makes Bexsero effective against a broad range of MenB strains. Supportive care with cool compresses and over-the-counter analgesics is usually sufficient, and reactogenicity does not typically worsen with subsequent doses.
No. Vasovagal syncope โ brief pallor, diaphoresis, bradycardia, transient loss of consciousness, and rapid recovery in the supine position โ is a parasympathetic reflex reaction that is especially common in adolescents receiving any injection, and it is one of the most common events reported after meningococcal vaccination in the 11-to-16-year age range. It is not an IgE-mediated allergy, does not respond to epinephrine, does not predict future vaccine reactions, and is not a contraindication to future doses. Vaccinating adolescents seated or lying down and observing for 15 minutes minimizes injury from syncope. Persistent hypotension, tachycardia, and wheeze distinguish true anaphylaxis from syncope.
Medical References
- [1]Mbaeyi SA, Bozio CH, Duffy J, et al. Meningococcal Vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020;69(9):1โ41.
- [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):868โ878.
- [3]Kelso JM, Greenhawt MJ, Li JT, et al. Adverse reactions to vaccines practice parameter 2012 update. J Allergy Clin Immunol 2012;130(1):25โ43.
- [4]CDC Pink Book โ Epidemiology and Prevention of Vaccine-Preventable Diseases, 14th ed., Meningococcal Disease chapter. 2021.
- [5]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):1533โ1540.
- [6]Wood RA, Berger M, Dreskin SC, et al. An algorithm for treatment of patients with hypersensitivity reactions after vaccines. Pediatrics 2008;122(3):e771โ777.
- [7]Nilsson L, Brockow K, Alm J, et al. Vaccination and allergy: EAACI position paper, practical aspects. Pediatr Allergy Immunol 2017;28(7):628โ640.
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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