Latex Allergy and Flu Vaccine Administration
For most patients with latex allergies, the flu vaccine can be safely administered, but those with severe (anaphylactic) latex allergies should only receive vaccines in vials or syringes without natural rubber components unless the benefits outweigh the risks. 1
Types of Latex Allergies and Risk Assessment
Contact-type (type 4) allergy: The most common type of latex sensitivity, usually resulting from prolonged contact with latex-containing gloves. Patients with this type of latex allergy can safely receive vaccines supplied in vials or syringes that contain dry natural rubber or natural rubber latex. 1
Severe (anaphylactic) allergy: This is a more serious allergic reaction to latex. For these patients, vaccines supplied in vials or syringes containing natural rubber should generally be avoided unless the benefit of vaccination outweighs the risk of an allergic reaction. 1
Evidence on Latex in Vaccines
Latex or dry natural rubber used in vaccine packaging is generally noted in the manufacturer's package insert. Always consult the package insert for any vaccine being administered to patients with latex allergies. 1
Vaccine components that may contain latex include syringe plungers, vial stoppers, and injection ports on intravascular tubing. These components may be made from dry natural rubber, which might contain the plant impurities responsible for allergic reactions, but in lesser amounts than natural rubber latex. 1
Synthetic rubber and synthetic latex, which are also used in medical supplies including some vaccine packaging, do not contain natural rubber or natural latex and therefore do not contain the impurities linked to allergic reactions. 1
Safety Data and Recommendations
Allergic reactions (including anaphylaxis) after vaccination procedures are rare. Only one known report of an allergic reaction after administering hepatitis B vaccine in a patient with known severe allergy (anaphylaxis) to latex has been published. 1
A review of the Vaccine Adverse Event Reporting System (VAERS) revealed only 28 cases of possible immediate-type hypersensitivity reactions in vaccine recipients with a history of allergy to latex, suggesting that the risk of allergic reactions possibly due to latex contamination of vaccines appears to be very small. 2
Clinical Decision Algorithm
Determine the type of latex allergy:
- If patient has contact-type (type 4) allergy to latex → Proceed with vaccination using standard vaccine preparations 1
- If patient has severe (anaphylactic) allergy to latex → Continue to step 2
For patients with severe latex allergy:
- Check the vaccine package insert to determine if the vaccine contains natural rubber components 1
- If the vaccine does NOT contain natural rubber → Proceed with vaccination
- If the vaccine DOES contain natural rubber → Continue to step 3
Risk-benefit assessment:
- Consider the risk of influenza infection versus the risk of allergic reaction
- If benefits outweigh risks (e.g., during flu epidemic or for high-risk patients) → Proceed with vaccination under close medical supervision with emergency equipment available 1
- If alternative latex-free vaccine formulations are available → Use the latex-free alternative
Important Considerations and Pitfalls
Always document latex allergy status in the patient's medical record and verify the components of the specific flu vaccine formulation being used. 1
Be aware that patients with latex allergies may also have cross-reactivity with certain foods (particularly banana, kiwi, and avocado), which may complicate their allergy profile. 3, 4
Maintain appropriate emergency equipment and medications to treat potential allergic reactions, especially when administering vaccines to patients with a history of severe latex allergy. 5
The presence of a latex allergy should not be used as a reason to avoid necessary vaccinations entirely, as the risk of vaccine-preventable diseases often outweighs the small risk of allergic reaction. 2