Risk of Anaphylaxis after Vaccination of Children and Adolescents

serious food allergies, in terms of severity of reactions and persistence of hypersensitivity. Approximately 50 to 100 people die each year in the United States as a result of unintended peanut ingestion. This well-designed and wellconducted study demonstrates that subcutaneous TNX-901 injections decrease total IgE levels in the blood and raise the threshold of sensitivity to peanut protein, in a dosedependent manner. Impressively, 24% of patients who received the 450-mg injections were able to tolerate up to 8 g of peanut protein without reactions. This increase in the threshold for reactivity could help prevent reactions to accidental peanut ingestion, but regular injections are required to maintain the elevated threshold. Such a treatment strategy, although expensive, might reduce the number of reactions to accidental peanut ingestion until more definitive disease-modifying therapies are developed. Unfortunately, TNX-901 is not available for treatment at this time and the humanized anti-IgE antibody Xolair (Genentech, South San Francisco, CA), which is now Food and Drug Administration-approved for use in asthma, has not been studied for similar benefits in peanut allergy.