Changes in IgE Levels Following One-Year Immunizations in Two Children with Food Allergy

Background
As food allergy has increased, so has the number of immunizations containing alum given to children. Knowing that alum contributes to the stimulation of IgE in mice, we question the impact of alum adjuvant on IgE production in children.

Methods
Two unrelated children presented to the Pediatric Allergy Clinic: an 8 month-old girl (Case 1) and a 12 month-old boy (Case 2).
Case 1: At 5 months of age, the otherwise healthy girl tasted peanut butter and developed hives and facial swelling within 20 minutes. Total and food allergen-specific IgE values were measured by ImmunoCAP 250 at ages (months) 8, 12, 12.7.
Case 2: At 8 months old, the otherwise healthy boy developed diffuse hives after eating scrambled egg. His total and food allergen-specific IgE values were measured at ages (months) 12 and 12.7.

Results
Case 1: At 8 months-old, her serum IgE values (in IU/mL) were total 61.4, peanut 13.6, almond 4.04, milk 3.84, egg 2.01, soy 1.6, and wheat 0.98, compared to total 44.1, peanut 11.2, almond 1.54, milk 2, egg 1.71, soy 1.62, and wheat 2.2 at 12 months-old. After the 12 month-old labs were drawn, she received the vaccines Prevnar13, hepatitis A, MMR, and Varicella. 3 weeks later, at 12.7 months-old, her IgE values were total 75.6, peanut 16.5, almond 2.18, milk 5.06, egg 3.4, soy 3.64, and wheat 3.75.
Case 2: At 12 months-old, the boy’s IgE values were total 21.1, egg 1.16, and peanut, milk, wheat, soy, cod, and shrimp <0.1. A week later, he received Prevnar13, MMR, and Varicella. 3 weeks later, at 13 months-old, his IgE values were total 23.8, egg 4.02, and peanut, milk, wheat, soy, cod, and shrimp <0.35 (measured by ImmunoCAP 1000).  

Conclusions
We report two cases of children who were sensitized to food allergens whose serum IgE levels increased after immunizations.  Case 1 shows total IgE and food allergen-specific IgE values that decreased from 8-12 months of age, a time interval during which she received no intramuscular alum. Three weeks after she received four vaccines (two of which contained alum), all of her IgE levels increased. In Case 2, the boy received three vaccines (one of which contained alum), and his total and egg IgE increased.  The results raise the hypothesis that alum-containing vaccines may increase, at least temporarily, the production of allergen-specific IgE levels.