US EPA

1314658 

Journal Article 

Letter 

Exacerbation of eczema by formalin-containing hepatitis B vaccine in formaldehyde-allergic patient 

Ring, J 

1986 

1 

The Lancet
ISSN: 0140-6736
EISSN: 1474-547X 

IPA/87/709027 

2 

8505 

522-523 

English 

2875273 

10.1016/s0140-6736(86)90397-1 

IPA COPYRIGHT: ASHP The case of a 24-yr-old nurse with a history of allergy to nickel sulfate and formaldehyde solution (formalin; I) who had an acute exacerbation of eczema the day after hepatitis B vaccines (H-B-Vax; II) injection is presented. HB-Vax contains hepatitis B antigen, sodium merthiolate, aluminum hydroxide and up to 0.02 mg/ml of I. The patient was treated with betamethasone dipropionate cream and zinc lotion. Patch-test reactions to H-B-Vax were negative. A second dose of hepatitis B vaccine, given a wk later, led to another exacerbation, which started 3-4 h after the injection with a severe itch that developed into mild erythematous lesions on the hands one day later. The third dose of the vaccine, given 3 months later, was tolerated well except for a mild generalized pruritus one day after the injection; it cleared spontaneously. The patient's generalized itch and exacerbation of eczema was probably due to I in the vaccine used. The negative skin tests with the vaccine are best explained by the low concentration of I in the preparation. It is not unusual for skin tests to be negative with low concentrations of a substance while systemic reactions occur with parenteral administration of a larger amount of allergen. It was concluded that intradermal test with hepatitis B vaccine is recommended before it is given to persons allergic to I. 

Hepatitis B vaccines; adverse reactions; formaldehyde preservatives; Formaldehyde solution; allergies; hepatitis B vaccines preservatives; Eczema; hepatitis B vaccines preservatives; Vaccines; hepatitis B; formaldehyde preservatives; hepatitis B vaccines preservatives; Drugs; Concentration; Preservatives; hepatitis B vaccines; HB-Vax; Formalin; HUMAN