Study: Anaphylaxis Extremely Rare As Result of Vaccine Administration

VaccineA recent study of children aged 16 and younger in the United Kingdom found that anaphylaxis rarely occurred as a result of common pediatric immunizations and not at all as a result of infant and preschool immunizations.

The findings, published online on January 23 in the Archives of Disease in Childhood,  are the result of a study conducted by Michel Erlewyn-Lajeunesse, M.B.B.S., of the University Hospital Southampton in the UK, and colleagues. They studied cases of anaphylaxis reported in the UK and Ireland between September 2008 and October 2009.

The researches found that seven out of 15 reported cases met the actual criteria for anaphylaxis following immunization. Six of the children (all of whom recovered) required epinephrine injections and intravenous fluids.

The estimated incidence was 12 cases per 100,000 doses for single component measles vaccine and 1.4 cases per million doses for the bivalent human papillomavirus vaccine. ”Anaphylaxis remains a rare adverse event following immunization. No cases were related to vaccines given as part of the ‘routine’ infant and preschool immunization program, despite over 5.5 million vaccines being delivered in this time period,” the authors wrote.

It should be noted that several authors disclosed financial ties to pharmaceutical companies and vaccine manufacturers.

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Virginia First Grader Dies of Allergic Reaction in School

A Virginia first grader, Ammaria Johnson, died Monday shortly after suffering an apparent allergic reaction to something she ate at school. Paramedics received an emergency call at 2:26PM and arrived shortly afterward to find Ammaria in cardiac arrest. She was pronounced dead after her arrival at Chippenham Medical Center.

Ammaria JohnsonHer mother, Laura Pendleton, told the local CBS affiliate that Ammaria was allergic to peanuts and that the school declined to accept an EpiPen (epinephrine injector) on her behalf last fall.

Though the cause must still be confirmed, this tragic death may have been avoidable had the school a stock of emergency epinephrine on hand. Legislation has been introduced in Congress that would provide states incentives to allow their schools to stock epinephrine and administer doses when necessary. We encourage you to contact your congressional representatives in support of the School Access to Emergency Epinephrine Act.

We urge parents of food allergic children to engage their school in developing a food allergy emergency action plan. The Food Allergy & Anaphylaxis Network (FAAN) has a template for such a plan in a number of languages.

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Study: Peanut Sensitivity Rises with Age in Children and Young Adults

University Medical Center GroningenThe results of a study recently published in the Journal of Allergy and Clinical Immunology indicate sensitivity to peanuts in allergic children and young adults rises with age. This may explain why adolescents suffer severe allergic reactions to peanuts more frequently than do younger children.

Researchers at the University Medical Center Groningen, the Netherlands reviewed data from 126 positive reactions to double-blind, placebo-controlled food challenges to peanuts conducted with children during the years 2001 to 2009. They tracked the exact dose required to elicit an allergic response as measured by IgE levels in the blood as a determinant of sensitivity. Though the study associates increasing age with greater peanut sensitivity, no significant associations were found for sex, the presence of asthma, or the severity of food reactions by history.

[Editor's Note: Parents should not despair - there are a number of promising peanut vaccine and desensitization therapies in the works that will hopefully bear fruit in the coming years.]

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Update to Safe Snack Guide: December 8, 2011

We have made a number of changes to our Safe Snack Guide as of this revision:

  • Sesame Seeds – No Longer Supported by This Guide

    After much deliberation, we have removed sesame seeds from the list of allergens that are addressed by this guide; i.e. from this revision forward, sesame seeds and their derivations may appear as ingredients in snacks listed in this guide. We realize this may prove a hardship for those with allergies to sesame but we feel that the current labeling regimen is inadequate to the task. We will resume support for sesame once FALCPA is augmented by legislation that expands the list of allergens to include it.

    Discontinue use of this guide for people who are allergic to sesame seeds.

  • Addition of Guide Download and Expiration Dates

    In addition to the revision date, each copy of the guide will now display the date it was downloaded as well as an expiration date after which the present copy should be discarded and a new copy downloaded. We have added this feature to ensure that our readers always have a current copy of the guide that reflects the latest revisions and product advisories.

  • Product Additions and Clarifications

    Responding to reader requests, we have added a variety of large (1.5 Qt) ice cream tubs to our guide which are especially popular for parties and special events. We have also clarified product information for a number of frozen treats such as pops, fudge bars and ice cups.

  • Disclaimer and Notes – Moved to First Page

    We have moved the disclaimer and notes section to the first page to ensure that our readers are fully aware of the limitations of our guide.

You can download the latest revision of the Safe Snack Guide by clicking here.

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Support the “School Access to Emergency Epinephrine Act”

CongressU.S. Senators Dick Durbin (D) and Mark Kirk (R) of Illinois have recently introduced the “School Access to Emergency Epinephrine Act” which could potentially safeguard the lives of millions of school children with known food allergies and many more that have not been diagnosed.

Roughly six million children in the U.S. are food-allergic with many of them at risk of developing anaphylaxis (a life threatening allergic reaction) when they ingest or simply come in contact with an allergen. The treatment of choice for anaphylaxis is epinephrine which must be administered immediately, often by auto-injector.

Studies have shown that as many as 25 percent of epinephrine injections administered at schools are given to children who have had no prior history of food allergy and as such do not have prescriptions for epinephrine. There are also situations where a child suffering an anaphylactic reaction requires a second dose of epinephrine but their school-held supply only provides for a single dose.

This legislation provides incentives to states to allow their schools to maintain a supply of epinephrine and administer it to any child that is having an anaphylactic reaction. It would make schools significantly safer by ensuring that children without a prescription or those with an insufficient dose on-hand would have access to this life saving drug.

The School Access to Emergency Epinephrine Act is endorsed by the Food Allergy & Anaphylaxis Network (FAAN); the American Academy of Allergy, Asthma & Immunology; and the American Academy of Pediatrics. We at SnackSafely.com strongly support passage of this legislation and urge you to contact your congressional representatives and voice your support.

You can view the original press release here.

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Open Letter: Why Your Child Can’t Bring Peanut Butter to School (and What You Can Do About It)

Dear Fellow Parent,

I understand your child will have to forgo peanut butter and jelly sandwiches at school in order to protect children with food allergies like mine. I realize this accommodation may seem extreme to you, especially since your child refuses to eat anything else but PB&J. Though I am sympathetic and can offer you a strategy for dealing with this, let me first explain why the school has adopted this rule.

Peanut Butter ALTERNATIVE and Jelly SandwichIn 2007, it was estimated that over 3 million children aged 18 years and under had some kind of food allergy1 and that number has been rising. Though there are many theories as to why this is, no one knows for sure. What we do know is that allergic reactions can range anywhere from mild – with symptoms like redness and itchiness – to anaphylaxis, a life threatening reaction that can include vomiting, difficulty breathing, and in extreme cases, death. To complicate matters, no one can predict with 100% certainty which children are at risk for anaphylaxis, and worse, a child doesn’t need to eat a food they are allergic to to have an anaphylactic reaction; contact with another child or an item that has been exposed to the allergen can sometimes be enough to trigger onset. Because of this, our children’s teacher carries an epinephrine injector, the treatment of choice if the unthinkable should happen, and why foods containing peanuts are prohibited from our children’s classroom.

Some think that children with food allergies should go to private school or be home schooled so as not to inconvenience the parents of “normal” children, but this is discriminatory thinking of days gone by. Thanks to Section 504 of the Rehabilitation Act of 1973, my child has the right to be accommodated any place that receives federal assistance, and that includes our school.2

Let me say thanks in advance for your understanding and compliance with the peanut butter ban as I fully understand that your family is making an accommodation to ensure the safety of mine. In return, I offer the following advice to help you transition your child from peanut butter to an alternative that is safe, more healthful, and acceptable to our school’s policy.

Peanut butter derives much of its taste from the roasting process. There are a number of other spreads available at the supermarket that use a similar roasting process and taste remarkably similar to peanut butter. My child likes sunflower seed butter, but soy nut butter is another alternative.

Now similar does not mean exactly like, so you’ll need to ease your child into a peanut butter alternative behind the scenes so they won’t taste the difference. Here’s the secret: when your child has lunch at home, simply mix 3/4 peanut butter with 1/4 peanut butter alternative, and on successive days change the proportion to more and more of the alternative spread. In no time your child will be enjoying PBA&J (peanut butter alternative and jelly ;-) sandwiches, and we’ll all breathe easier knowing our children are safe, secure and happy.

Thanks again and please feel free to contact me if you have any questions.

Sincerely,
Concerned Parent

P.S.: SnackSafely.com has a list of commonly available snacks that are free of peanuts, tree nuts and eggs – perfect for the next classroom party.

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Update to Safe Snack Guide: October 26, 2011

Please note that we have made two revisions to our Safe Snack Guide:

  1. Kraft Jet-Puffed Marshmallows – Product Removed

    Based on reader feedback, we have received an anecdotal report of a possible reaction to peanut contamination which we cannot confirm. As a precaution we are removing the product from our guide.

  2. Disclaimer and Notes – Updated

    We have updated the disclaimer for clarity and have added notes to better inform readers of the use of the guide and our website.

You can download the latest revision of the Safe Snack Guide by clicking here.

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White House Petition to Expand Food Labeling

The White HouseAs you may know, only eight major food ingredients are covered under FALCPA, the act of congress that establishes rules for the disclosure of allergens on a product’s label. FALCPA has many deficiencies, among them the small number of allergens it covers.

There is currently a petition circulating on the White House website to expand the allergens covered by FALCPA to include sesame seeds and mustard seeds, two common food ingredients that can cause severe reactions including anaphylaxis. We are asking all our readers to please sign the petition by visiting this petition link. With your help, people with allergies to these ingredients will be afforded better protection with more complete allergen disclosure on food labels.

If you are interested in learning more about FALCPA, see our article: 5 Things You Should Know About Food Labels. Our expansive snack guide, which lists snacks that are all sesame seed free as well as peanut, tree nut and egg free, can be found by clicking here.

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4 Halloween Strategies for Food Allergic Kids

Halloween is a time of year that strikes fear into the hearts of the parents of children with food allergies. Here are four strategies to help you and your child cope and enjoy the holiday:

  1. Engage officials at your child’s school, sporting activities, clubs and organizations. Have them commit to restricting snacks for parties and social events to an approved list that is deemed allergen safe for all food allergic children who share the facility.

    Some important guidelines:

    • All children (not just those with allergies) and their parents must restrict snacks to those on the list to avoid any chance of contact reactions.
    • All snacks must remain unopened in their original packaging to allow those adults responsible to perform a final check of the ingredient list before the snack is served.
    • Homemade snacks must not be permitted. While parents may have the best of intentions, cross contamination can occur in any kitchen where allergens are not normally excluded. There is also no way for the adult responsible for a food allergic child to ensure that all the ingredients used to make a homemade snack are free of specific allergens.
  2. Arrange a safe trick-or-treating community with other families of children with food allergies in your neighborhood. Agree within the group to restrict treat handouts to those on an approved, allergen-free list. Take turns trick-or-treating at those homes within the group.
  3. If you do decide to trick-or-treat outside of your “safe” group, buy some of your child’s favorite safe snacks and agree to swap them one-for-one for unsafe snacks at the end of the evening. Make sure that your child understands:
    • Not to accept any unwrapped or homemade snacks of any kind.
    • Never to open or eat any snack until it has been approved by the parent after reading the label.
  4. Pass it on – Be sure to buy common allergen-free snacks to hand out to trick-or-treaters who visit your home!

SnackSafely.com maintains an up-to-date, well researched snack guide perfect for Halloween parties and activities. It features a wide variety of snacks free of peanuts, tree nuts, eggs and sesame seeds. Find it by clicking here.

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5 Things You Should Know About Food Labels

Do you have food allergies or are you responsible for someone who does? You may think you’re a pro at reading food labels, but here are five things you should know about US food labeling requirements:

  1. Current labeling requirements regarding food allergies are dictated by an act of Congress known as FALCPA which became effective January 1, 2006.
  2. FALCPA mandates that manufacturers highlight the presence of eight major food allergens as ingredients in their products:
    • Milk
    • Eggs
    • Fish (e.g., bass, flounder, cod)
    • Crustacean Shellfish (e.g., crab, lobster, shrimp)
    • Tree Nuts (e.g., almonds, walnuts, pecans)
    • Peanuts
    • Wheat
    • Soybeans
  3. Other than these major allergens, manufacturers have no responsibility to highlight the presence of other potential allergens. If you are concerned about allergies to other food items (e.g. sesame seeds or strawberries) you must scrutinize the individual ingredients on the label.
  4. The presence of a major food allergen as an ingredient must be disclosed in one of two ways:
    1. The name of the food source of a major food allergen must appear in parentheses following the name of the ingredient.

      Examples: “lecithin (soy),” “flour (wheat),” and “whey (milk)”

    2. Immediately after or next to the list of ingredients in a “contains” statement.

      Example: “Contains Wheat, Milk, and Soy.

  5. Contrary to popular belief, manufacturers are not required to disclose potential allergens that may be introduced as part of the manufacturing process. All disclosures such as “Made in a factory that also processes peanuts” are entirely voluntary. There are no standards for the wording of these disclosures or guidelines for when they should be used, so consider them with caution.

Source: Food Allergen Labeling And Consumer Protection Act of 2004 Questions and Answers

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