Ractions to hymenoptera venom in children: to vaccinate or not to vaccinate?

Key words: Specific immunotherapy, Allergy, Hymenoptera venom

Hymenoptera venom allergy is a rare occurrence in children, so paediatricians are frequently unprepared and thus incapable of giving adequate answers. The allergy has usually a benign natural history: systemic reactions characterized only by cutaneous manifestation can either disappear completely, or maintain the same, low severity in case of following punctures. Severe systemic reactions presenting with respiratory and/or cardiocirculatory symptoms and/or laryngeal oedema, exceptionally fatal in paediatric age, are a strong indication for specific immunotherapy (SIT). There are three important reasons for this statement: contrary to common past belief, severe systemic reactions do not disappear rapidly after the paediatric age; SIT for hymenoptera venom is very effective and its effectiveness persists for years after suspension; affected patients' and families' quality of life is frequently lowered by the fear of new punctures and the prescription of adrenaline for auto-injection often worsens the fear instead of helping.