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Unexpected outcome (positive or negative) including adverse drug reactions
Hypersensitivity reaction to human papillomavirus vaccine due to polysorbate 80
  1. Iuliana Badiu1,
  2. Massimo Geuna2,
  3. Enrico Heffler1,
  4. Giovanni Rolla1
  1. 1Allergy and Clinical Immunology, University of Torino and AO Ordine Mauriziano, Torino, Italy
  2. 2Laboratory of Immunopathology, AO Ordine Mauriziano of Torino, Torino, Italy
  1. Correspondence to Professor Giovanni Rolla, grolla{at}


A 17-year-old girl reported generalised urticaria, eyelid angioedema, rhino-conjunctivitis, dyspnoea and wheezing 1 h after third intramuscular administration of quadrivalent human papilloma virus vaccine (Gardasil). She was treated with antihistamine, and corticosteroids with prompt relief of rhinitis and dyspnoea, while urticaria and angioedema lasted 24 h. Intradermal test with Gardasil, which contains polysorbate 80 (PS80), resulted positive, while skin tests with the bivalent vaccine were negative. Prick test performed with PS80 resulted positive in the patient and negative in ten healthy controls. The CD203 basophil activation test result was negative for PS80 at all the tested dilutions and specific IgE was not found. As flu vaccine was recommended, the authors skin tested two flu vaccine, one containing PS80 (Fluarix, GSK), which resulted positive and another flu vaccine with no adjuvant or preservative (Vaxigrip, Sanofi Pasteur MSD), which gave negative results. The patient then received Vaxigrip without adverse reactions.

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  • Competing interests None.

  • Patient consent Obtained.