Latex Allergy and Vaccines

 

Hard, dry latex is minimally processed and is used to make vial closures for some vaccines. There is concern that latex proteins may be mixed with the medication through packaging and storage of the vaccine vial, and also through puncturing the vial stopper to “draw up” the vaccine.

The same concern exists with vaccines that are stored in syringes with latex in the plungers.

The extent of risk is unknown, however, because information regarding the precise composition of the closure in any particular drug packaging is not always accessible. There are other potential allergens in vaccines such as gelatin and eggs which may contribute to allergic reactions.

Therefore, the reported risk of latex allergic reactions to vaccines appears very small in comparison with the number of vaccines that are administered each year.

Photo of doctor giving an injection to a young patient

Precautionary measures for vaccination with a latex allergy

Current practice recommendations (precautionary measures) are based on limited data. Therefore, they should be viewed as compromises rather than solutions.

“Popping the top”

“Popping the top” prevents the puncturing of a latex stopper for safer administration. However, there is still a possibility that latex allergic proteins have contaminated the medicine during the period of storage. Also, other contaminants may enter the medication if the vial is opened.

“One stick rule”

The “one stick rule” assumes that a single stick through the vial seal minimizes latex allergen distribution into the medication, while maintaining a closed system that limits potential for contamination. However, it does not adequately address the possibility that latex allergen can seep into medications during both shipping and storage, as well as during the single puncturing event.

Post vaccination observation

Post-vaccination observation by a qualified medical professional for a period of at least 15 minutes, and up to 2 hours.

Other recommendations for administering vaccines in latex-allergic patients

  • Use ampules of medications that do not contain latex when the content is known (most have less than 20% latex content).
  • Use a glass syringe. Otherwise, inject immediately after withdrawal.
  • Wear latex free gloves when administering vaccinations.
  • Avoid applying bandages or plasters if content is unknown.
  • Look for the following caution on medical products but be aware that not all latex containing products will be labelled, “Caution: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions.”
    Screening questions that clinicians must ask before administering vaccines that may contain latex:

    • Do you have spina bifida?
    • Have you had several surgeries throughout your life?
    • Do you have Allergies to avocados, bananas, kiwis, chestnuts or apples?
    • Do your lips swell when you blow up a balloon?
    • Do you have a history of rashes, itching, hives, eye irritation, runny nose or asthmatic symptoms (coughing, wheezing or bronchospasms) after handling gloves, balloons, condoms, or other latex items?
    • Is your mouth itchy after dental work?
    • Do you have frequent contact with natural rubber products either at home or work?
    • Have you ever had an anaphylaxis of unknown origin?
    While there appears to be a risk for latex-sensitive people when taking vaccinations, there is a lack of published supporting evidence. Thus, latex sensitivity or a local allergic reaction is not regarded as a contraindication to receiving needed vaccines unless there is a history of a severe allergic reaction. If there is a history of severe allergic reaction, the vaccination should be avoided unless the benefit of vaccination outweighs the risk of an allergic reaction.
    Latex in Vaccine Packaging – CDC
    Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices
    ASBAH is grateful to Sue Lockwood (ALAA) and Dr. Robert Hamilton (Professor of Medicine and Pathology, Johns Hopkins University School of Medicine) for their contributions to this informational material.

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