Combating high-priority biological agents: What to do with drug-allergic patients and those for whom vaccination is contraindicated?

• Published in: Journal of allergy and clinical immunology 2003-10, Vol.112 (4), p.675-682
• Main Authors: Gruchalla, Rebecca S, Jones, James
• Format: Article
• Language: English
• Subjects: Allergic diseases; anthrax; Anti-Bacterial Agents - adverse effects; antibiotic allergy; Antitoxins - adverse effects; Biological & chemical terrorism; Biological & chemical weapons; Biological and medical sciences; Bioterrorism; Botulism; Botulism - drug therapy; Category A biologic agents; Contraindications; Drug Hypersensitivity; Epidemiology. Vaccinations; General aspects; Humans; Immunization; Immunoglobulins - adverse effects; Immunopathology; Infectious diseases; Medical sciences; Mortality; plague; Plague - drug therapy; Plague - prevention & control; Plague Vaccine - adverse effects; smallpox; Smallpox Vaccine - adverse effects; Vaccination - adverse effects; vaccine-related adverse reactions; Vaccines; Vaccinia - immunology; Vaccinia - prevention & control
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/j.jaci.2003.08.001

The threat of bioterrorism continues to be a very real one. Regularly, there are news stories on bioterrorism-related topics: What biologic weapons will our enemies likely use to attack the United States? How prepared is our country to successfully counter such attacks? Although these critical questions are being addressed by the leaders of our country, allergists-immunologists, too, will have to grapple with difficult questions during these uncertain and frightening times. We care for a special group of patients with various allergic and immunologic disorders. Some of our patients have immunodeficiency disorders that might preclude them from receiving life-saving vaccines. Our patients with drug allergies are fearful that should they become infected with a biologic agent, they will not be able to receive appropriate treatment. In this article we focus on the various vaccine-related and antibiotic-related adverse effects that the allergist-immunologist might see during treatment of infections caused by Category A agents. Where possible, potential management approaches are outlined.