Friday Dr Q&A with Dr Liew – Vaccines and Cross-Reaction

Dr Liew Woei Kang

Marcie, who inspired MarcieMom to start this blog, doesn’t have any allergy and thus, this blog has been focused on eczema. Recognizing that there are many parents whose child also have allergy, MarcieMom invites Dr Liew Woei Kang, Paediatrician with special interest in Allergy, Immunology & Rheumatology to share more about managing allergy for eczema children.

More about Dr Liew: Dr. Liew practices at the SBCC Baby & Child Clinic and is also a visiting consultant to KK Hospital. He was also awarded several research grants from the National Medical Research Council, Singhealth Foundation and KKH Research centre to pursue clinical research in paediatric anaphylaxis, drug allergy, primary immunodeficiencies and Kawasaki disease. He is also the President of Singapore’s Asthma & Allergy Association which is currently administering the very first eczema fund (initiated by MarcieMom’s donation) for low income patients in Singapore.

MarcieMom: On vaccines, there is so much discussion out there where even doctors are coming out to say that vaccines are unnecessary and pharmaceutical companies are coming up with more and more vaccines that are unnecessary and even harmful for our children. Some parents may be opting their child out of vaccines due to egg protein included in some of the vaccines. What’s your recommendation on this and when should a parent seriously questions a vaccine before letting his/her child have it?

Dr Liew: Vaccines are the one of the proven public health measures to reduce mortality from infectious diseases. Vaccines are produced for significant infectious diseases. There is no link between vaccination and allergies. Traces of egg proteins can be found in influenza vaccines and specialised vaccines like yellow fever. Egg allergic patients should discuss the risk benefit ratios of receiving these vaccines. MMR vaccines are safe for egg allergic patients.

MarcieMom: On antibiotics, I’ve read online that antibiotics are mostly unnecessary since they are only effective against bacteria yet it is so common for general practitioners to prescribe antibiotics! (in fact, I always have to refuse the prescription because it’s just a common flu!) Antibiotics are also known to cause allergic reaction, what would be your recommendation?

Dr Liew: Antibiotics should only be prescribed for bacterial infections.

MarcieMom: On cross-reaction, it’s commonly heard of when a child is allergic to birch pollen, he/she is also allergic to apple. Or a child who is allergic to latex is also allergic to kiwi. Can such allergy be identified by allergy tests? Also, what are some of the common allergies that you can point our parents to, so that they are aware if their child is allergic to one thing, they should probably avoid something else.

Dr Liew: Cross-reactive allergens occur due to the similarity of one protein to another, usually within the same botany taxonomy. They can be easily tested by skin prick test or blood IgE testing. A good example would be most cow’s milk allergic patients are allergic to goat’s milk as there is an approximately 95% similarity between the two.

MarcieMom: Thank you Dr Liew, it’s such a great pleasure to have you explaining all these allergy questions that many parents have, we are all so grateful!

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