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Hypersensitivity Reactions to Vaccine Constituents: A Case Series and Review of the Literature

Leventhal, Jonathan S. BA; Berger, Emily M. MD; Brauer, Jeremy A. MD; Cohen, David E. MD, MPH

doi: 10.1097/DER.0b013e31825228cf

Vaccines are composed of immunogens, preservatives, adjuvants, antibiotics, and manufacturing by-products. Components of vaccines may rarely elicit adverse reactions in susceptible individuals, thus raising concerns regarding vaccine safety. In this report, we add to the medical literature 3 cases of cutaneous delayed-type hypersensitivity to the vaccine preservative aluminum. We provide a review of major constituents in vaccines that have elicited immediate-type or delayed-type hypersensitivity reactions and describe their clinical manifestations. We include a table of the Food and Drug Administration–approved vaccines, which lists the quantities of major components including ovalbumin (egg protein), gelatin, aluminum, neomycin, 2-phenoxyethanol, thimerosal, and formaldehyde. Our goals were to inform physicians on the variety of hypersensitivity reactions to common vaccines and to provide information on the choice of vaccines in patients with suspected hypersensitivity.

Author Information

From the Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY.

Address reprint requests to David E. Cohen, MD, MPH, Ronald O. Perelman Department of Dermatology, New York University School of Medicine, 550 First Ave Suite H100, New York, NY 10016. E-mail:

The authors have no funding or conflicts of interest to declare.

©2012American Contact Dermatitis Society, All Right Reserved

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