Alum-Containing Vaccines Increase Total and Food Allergen-Specific IgE, and Cow's Milk Oral Desensitization Increases Bosd4 IgG4 While Peanut Avoidance Increases Arah2 IgE: The Complexity of Today's Child with Food Allergy.
Sunday, March 6, 2016
South Exhibit Hall H (Convention Center)
Alice E.W. Hoyt, MD, Alexander J. Schuyler, BS BA, Peter W. Heymann, MD, Thomas A.E. Platts-Mills, MD PhD FAAAAI, Scott P. Commins, MD PhD
Rationale: The era of food allergy began with the post-millennial generation, the same faction who received new immunizations during early childhood. Many of these vaccines contain alum, an adjuvant known to induce allergic phenotypes. We detail a child with peanut and cow’s milk allergy and her response to immunizations, allergen avoidance, and oral desensitization.

Methods: IgE (IU/mL) and IgG4 (mcg/mL) were measured by ImmunoCAP.

Results: From ages 8 to 12 months, our patient’s total IgE decreased from 61.4 to 44.1; peanut decreased from 13.6 to 11.2, and cow’s milk decreased from 3.84 to 2. She then received 12-month vaccines.  Three weeks later, her IgE sharply increased from 44.1 to 75.6; her peanut IgE increased from 11.2 to 16.5, and her milk IgE increased from 2 to 5.06. She then avoided alum-containing vaccines and, by age 16 months, her IgE decreased to 51; her peanut decreased to 13.7, and her milk decreased 1.54. Despite peanut-avoidance, Arah2 IgE continued to rise while all other IgE values decreased. She began cow’s milk oral desensitization around 13 months-old. Peanut component IgG4 values exhibited minimal changes. Bosd4, Bosd5, and Bosd8 IgG4 changed minimally after vaccines; however, post-desensitization IgG4 values were remarkably higher - Bosd4 increased from 0.46 to 16, Bosd5 increased from 0.54 to 5.32, and Bosd8 increased from 0.75 to 2.94 at 16 months.

Conclusions: Alum-containing vaccines increased IgE, a phenomenon we have previously observed, whereas milk desensitization increased milk-component IgG4, a trend we have reported post-peanut OIT.