Pediatria pre prax 6/2003
Kdy indikovat imunologické a alergologické vyšetření před a po očkování?
When to indicate an immunological and allergological examination before and after vaccination? The goal of an indication of active immunization is to exclude severe immunodeficiency before an administration of live vaccines, not to administer an allergen, which can induce severe anaphylactic reaction. If we suspect an immunodeficiency before administration of live vaccines, it is necessary to examine at least basic immunological parameters e.g. IgG, IgA, IgM and IgE immunoglobulins, complete blood and differential count, complement activity – tests CH50 and CH100 and phagocytosis – particularly the ability of oxidative outburst of granulocytes, usually an NBT test. Severe overall anaphylactic or anaphylactoid reaction resulting form the vaccine or its compound is a contraindication to administration of such vaccine. Skin tests and examination of specific IgE antibodies to allergens, which are contained in vaccines, are auxiliary tests only. Titres of specific antibodies after the active immunization are evaluated in children with immunodeficiency after a period of 6 to 8 weeks post vaccination. These examinations are indicated before vaccination in patients with autoimmune and immunopathological diseases or in children with major reactions after previous vaccinations, to exclude overstimulation of immune system. Key words: vaccination, immunodeficiency, allergy, immunological and allergological tests
