Children with vaccination granulomas and aluminum contact allergy: Evaluation of predispositions, avoidance behavior, and quality of life

Contact Dermatitis. 2020 Aug;83(2):99-107. doi: 10.1111/cod.13538. Epub 2020 Apr 14.

Abstract

Background: Aluminum contact allergy is mostly seen in children with vaccination granulomas, following immunization with aluminum-adsorbed childhood vaccines.

Objectives: To characterize a cohort of children with vaccination granulomas and aluminum allergy concerning early life conditions, exacerbating factors, avoidance behavior, treatments, and potential impact on quality of life.

Methods: A questionnaire study was conducted among 177 children aged 0 to 15 years with vaccination granulomas and aluminum allergy, and a reference group of 61 children aged 3 to 14 years with various types of dermatitis undergoing patch testing.

Results: All children in the granuloma group were reportedly affected by itch. Infection exacerbated the itch in 59%. Other worsening factors were eating tin-foiled/canned food (31%) and use of aluminum-containing sunscreen (46%). Many parents took precautions to avoid aluminum exposure. Children with granulomas were more likely to be nonadherent to the National Vaccination Program than the reference group (27% vs 2%, P < .001). Parents in the granuloma group reported a decreased life quality for both parents and children compared with the reference group.

Conclusions: Itching vaccination granulomas and aluminum allergy have a considerable negative impact on affected children and their families, causing avoidance behavior, reduced adherence to vaccination programs, and a negative effect on the overall life quality.

Keywords: allergic contact dermatitis; aluminum; children; contact allergy; granuloma; patch test; quality of life; questionnaire; vaccine.

MeSH terms

  • Adolescent
  • Aluminum / adverse effects
  • Avoidance Learning*
  • Child
  • Child, Preschool
  • Dermatitis, Allergic Contact / complications
  • Dermatitis, Allergic Contact / etiology*
  • Dermatitis, Allergic Contact / psychology
  • Female
  • Granuloma / complications
  • Granuloma / etiology*
  • Granuloma / psychology
  • Humans
  • Infant
  • Male
  • Pruritus / etiology*
  • Quality of Life*
  • Risk Factors
  • Sunscreening Agents / therapeutic use
  • Surveys and Questionnaires
  • Vaccination / statistics & numerical data
  • Vaccines / adverse effects
  • Vaccines / chemistry

Substances

  • Sunscreening Agents
  • Vaccines
  • Aluminum