{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T20:32:37Z","timestamp":1792096357154,"version":"4.4.0"},"reference-count":62,"publisher":"Oceanside Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2022,1,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Recent advances in vaccination against the severe acute respiratory syndrome coronavirus 2 pandemic have brought allergists and dermatologists to the forefront because both immediate and delayed hypersensitivity reactions have been reported.  <jats:bold>Objective:<\/jats:bold>\n This literature review focused on delayed reactions to vaccines, including possible causative agents and practical information on how to diagnose, evaluate with patch testing, and manage subsequent dose administration.  <jats:bold>Methods:<\/jats:bold> Currently published reviews and case reports\n in PubMed, along with data on vaccines from the Centers for Disease Control and Prevention web site. Relevant case reports and reviews that focused on delayed reactions to vaccines were selected.  <jats:bold>Results:<\/jats:bold> Most delayed hypersensitivity reactions to vaccines include cutaneous\n manifestations, which vary from local persistent pruritic nodules to systemic rashes. The onset is usually within a few days but can be delayed by weeks. Multiple excipients have been identified that have been implicated in delayed vaccine reactions, including thimerosal, formaldehyde, aluminum,\n antibiotics, and gelatin. Treatment with antihistamines, topical corticosteroids, or systemic corticosteroids alleviates symptoms in most patients. Such reactions are generally not contraindications to future vaccination. However, for more-severe reactions, patch testing for causative agents\n can be used to aid in diagnosis and approach further vaccination.  <jats:bold>Conclusion:<\/jats:bold> Delayed-type hypersensitivity reactions to vaccines are not uncommon. If needed, patch testing can be used to confirm agents, including antibiotics, formaldehyde, thimerosal, and aluminum. In\n most cases, delayed cutaneous reactions are not contraindications to further vaccine administration.<\/jats:p>","DOI":"10.2500\/aap.2022.43.210105","type":"journal-article","created":{"date-parts":[[2022,1,5]],"date-time":"2022-01-05T12:03:14Z","timestamp":1641384194000},"page":"20-29","source":"Crossref","is-referenced-by-count":15,"title":["Delayed allergic skin reactions to vaccines"],"prefix":"10.2500","volume":"43","author":[{"given":"Marcella R.","family":"Aquino","sequence":"first","affiliation":[{"name":"From the Allergy and Immunology Section, Department of Pediatrics, Hasbro Children's Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa A.","family":"Bingemann","sequence":"additional","affiliation":[{"name":"Divisions of Allergy, Immunology and Rheumatology and Pediatric Allergy and Immunology, University of Rochester, Rochester, Newyork;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Nanda","sequence":"additional","affiliation":[{"name":"Asthma and Allergy Center, Lewisville and Flower Mound, Texas, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M.","family":"Maples","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, Children's Hospital of The King's Daughters, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"bcr2015211917","DOI":"10.1136\/bcr-2015-211917","article-title":"Serum sickness-like reaction after influenza vaccination","volume":"2015","author":"Chiong","year":"2015","journal-title":"BMJ Case Rep"},{"key":"B2","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1111\/1346-8138.13487","article-title":"Influenza vaccine-induced acute generalized exanthematous pustulosis during pregnancy","volume":"44","author":"Matsuo","year":"2017","journal-title":"J Dermatol"},{"key":"B3","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/DER.0b013e31825228cf","article-title":"Hypersensitivity reactions to vaccine constituents: a case series and review of the literature","volume":"23","author":"Leventhal","year":"2012","journal-title":"Dermatitis"},{"key":"B4","doi-asserted-by":"crossref","first-page":"e771","DOI":"10.1542\/peds.2008-1002","article-title":"An algorithm for treatment of patients with hypersensitivity reactions after vaccines","volume":"122","author":"Wood","year":"2008","journal-title":"Pediatrics"},{"key":"B5","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.jaci.2017.12.971","article-title":"Vaccine-associated hypersensitivity","volume":"141","author":"McNeil","year":"2018","journal-title":"J Allergy Clin Immunol"},{"key":"B6","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1097\/00000478-199305000-00012","article-title":"Postimmunization (vaccination) injection-site reactions. 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