Alerji ve Aşılama

Aşılama morbiditesi ve mortalitesi yüksek bulaşıcı hastalıklardan korunmada en etkin toplum sağlığı uygulamasıdır. Aşılama hızının artmasıyla bulaşıcı hastalıklar ciddi oranda azalmıştır. Günümüzde hastalıkların azalmasıyla da dikkatler aşıların istenmeyen etkileri üzerine toplanmıştır. Bu istenmeyen etkilerden en önemli ve sık görüleni ciddi alerjik reaksiyonlardır. Bir aşıya karşı ciddi bir alerjik reaksiyon öyküsü, aynı aşının ilave dozlarına kontrendikasyon olarak düşünülmelidir. Ancak aşıya karşı ciddi alerjik yanıt nadir görülür, herhangi bir bireyde olabilir ve önceden tahmini güçtür. Neredeyse tüm aşılar anafilaksiyi tetikleme potansiyeline sahiptir ve aşı bileşenlerinin tümü de anafilaksiye neden olabilmektedir. Aşılama sonrası görülen alerjik reaksiyonlar, aşıdaki mikrobial antijenlere, stabilizatörlere, koruyuculara, adjuvan ve üretimden kalan kirleticilere bağlı olabilir. Bu bileşenlerin çoğu, bileşene olası aşırı duyarlılığı olan çoğu hastada genellikle alerjik reaksiyonları indüklemek için yetersiz olan küçük miktarlarda bulunur. Aşı sonrası oluşan reaksiyonun alerjik reaksiyon olup olmadığı doğru tespit edilmelidir. Alerjik reaksiyonların aşı ile çakışan klinik tablolardan ayrımı önemlidir. Aşılamanın kontrendikasyonlarının net belirlenmemesi sonucu alerjiye karşı korku ve belirsizlik, alerjisi olan veya olmayan çocuklar ve yetişkinler için eksik aşılanmaya neden olabilmektedir. Bu nedenle aşılama sonrası şüpheli alerjik reaksiyonu olan hastanın yeniden aşılanması için doğru yaklaşımın bilinmesi gerekir. Bunun yanı sıra özellikle astım gibi kronik pulmoner bir hastalığı olan bireylerin pnömokok ve influenza aşıları ile aşılanmaları önerilmektedir.

Anahtar Kelimeler:

çocuk, aşı, bağışıklama

Vaccination is the most effective public health practice to prevent infectious diseases with high morbidity and mortality. As the rate of vaccination increased, infectious diseases decreased considerably. Today, with the reduction of diseases, attention has been focused on the side effects of vaccines. The most important and common of these side effects are serious allergic reactions. A history of a serious allergic reaction to a vaccine should be considered as a contraindication to additional doses of the same vaccine. However, a severe allergic response to the vaccine is rare, can occur in any individual and is difficult to predict. Almost all vaccines have the potential to trigger anaphylaxis and all vaccine components can cause anaphylaxis. Allergic reactions after vaccination may be due to microbial antigens, stabilizers, preservatives, adjuvants and contaminants from production. Most of these components are often present in small amounts that are insufficient to induce allergic reactions in most patients with possible hypersensitivity to the component. It should be determined whether the reaction after the vaccination is allergic or not. It is important to differentiate allergic reactions from the clinical picture that coincides with the vaccine. Fear and uncertainty against allergies may result in incomplete vaccination for children and adults with or without allergies, as the contraindications of vaccination are not clearly defined. Therefore, it is necessary to know the correct approach for re-vaccination of a patient with suspected allergic reaction after vaccination. In addition, vaccination with pneumococcal and influenza vaccines is recommended for individuals with chronic pulmonary disease, such as asthma.

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