Send to

Choose Destination
World Allergy Organ J. 2016 Sep 16;9(1):32. doi: 10.1186/s40413-016-0120-5. eCollection 2016.

International Consensus (ICON): allergic reactions to vaccines.

Author information

Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Denver School of Medicine, Aurora, CO USA.
Institute for Vaccine Safety, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA.
Division of Allergy, Asthma, and Immunology, Scripps Clinic, San Diego, CA USA.
The Division of Pediatric Allergy and Immunology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD USA.
Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN USA.
Division of Pediatric Infectious Diseases, Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN USA.
Department of Pediatrics, University Hospitals of Geneva and Medical School, University of Geneva, Geneva, Switzerland.
Department of Medicine and Pediatrics, Uniformed Services University of the Health Sciences, Allergy-Immunology-Immunization, Walter Reed National Military Medical Center, Bethesda, MD USA.
Disipline of Paediatrics, School of Medicine, University of Adelaide, Adelaide, South Australia Australia.
Department Paediatrics, Pulmonology and Allergy service, Necker-Enfants Malades Hospital, 149 rue de Sèvres, 75015 Paris, France.
Département de Pneumologie et Addictologie, Hôpital Arnaud de Villeneuve - University Hospital of Montpellier, 34295 Montpellier cedex 05 - FRANCE and Sorbonne Universités, UPMC Paris 06, UMR-S 1136 INSERM, IPLESP, Equipe EPAR, 75013 Paris, France.
Allergy and Clinical Immunology Department, Centro Médico Docente La Trinidad, Caracas, Venezuela.
Food Allergy Referral Centre Department of Women and Child health, University of Padua, Padua, Italy.
Division of Allergic Diseases, Mayo Clinic, Rochester, MN USA.
Allergy Asthma and Immunology, Emek Medical Center, Afula, and the Rappaport Faculty of Medicine, Technion- Israel Institute of Technology, Haifa, Israel.
Allergy-Immunology Division, Children's Mercy Hospital and the University of Missouri-Kansas City School of Medicine, Kansas City, MO USA.



Routine immunization, one of the most effective public health interventions, has effectively reduced death and morbidity due to a variety of infectious diseases. However, allergic reactions to vaccines occur very rarely and can be life threatening. Given the large numbers of vaccines administered worldwide, there is a need for an international consensus regarding the evaluation and management of allergic reactions to vaccines.


Following a review of the literature, and with the active participation of representatives from the World Allergy Organization (WAO), the European Academy of Allergy and Clinical Immunology (EAACI), the American Academy of Allergy, Asthma, and Immunology (AAAAI), and the American College of Allergy, Asthma, and Immunology (ACAAI), the final committee was formed with the purpose of having members who represented a wide-range of countries, had previously worked on vaccine safety, and included both allergist/immunologists as well as vaccinologists.


Consensus was reached on a variety of topics, including: definition of immediate allergic reactions, including anaphylaxis, approaches to distinguish association from causality, approaches to patients with a history of an allergic reaction to a previous vaccine, and approaches to patients with a history of an allergic reaction to components of vaccines.


This document provides comprehensive and internationally accepted guidelines and access to on-line documents to help practitioners around the world identify allergic reactions following immunization. It also provides a framework for the evaluation and further management of patients who present either following an allergic reaction to a vaccine or with a history of allergy to a component of vaccines.


Allergic reactions; Allergy; Anaphylaxis; Causality; Components; Consensus; International; Vaccine

Supplemental Content

Full text links

Icon for BioMed Central Icon for PubMed Central
Loading ...
Support Center