Canadian Immunization Guide: “Anaphylaxis and other acute reactions following vaccination” chapter update
Bibliographic record
Abstract
BACKGROUND: The Canadian Immunization Guide (CIG) is a comprehensive resource on immunization for health professionals and vaccine program decision-makers. It is developed based on the evidence-based recommendations of the National Advisory Committee on Immunization (NACI). The NACI Vaccine Safety Working Group (VSWG) is comprised of NACI members, liaison members and external experts. The World Allergy Organization now recommends that antihistamines should not be used in the initial treatment of anaphylaxis. The update of the chapter was also used to provide further information and clarity to several tables in the chapter. METHODS: In updating the CIG anaphylaxis guidance, VSWG conducted an environmental scan, a review of relevant literature and consulted international and Canadian experts and professional societies. RESULTS: The use of diphenhydramine hydrochloride as adjunctive treatment in the management of anaphylaxis in a community setting is no longer recommended. Other notable changes made to the chapter include the following: 1) retitled: "Anaphylaxis and other acute reactions following vaccination"; 2) inclusion of new tables: "Key distinguishing features of anaphylaxis and vasovagal syncope" and "Signs and symptoms of anaphylaxis"; and 3) updated tables: "Anaphylaxis management kit: recommended items" and "Dosage of intramuscular EPINEPHrine 1:1000 (1 mg/mL) solution, by age or weight". CONCLUSION: The updated CIG chapter provides healthcare providers with further clarity in recognizing and managing anaphylaxis in community settings. The updated intramuscular epinephrine dosage table will aid in optimal epinephrine administration, while the revised guidance against the use of diphenhydramine hydrochloride will prevent its unnecessary stockpiling in preparation for potential mass vaccination clinics related to the coronavirus disease 2019 pandemic.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.022 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.002 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.003 | 0.005 |
| Insufficient payload (model declined to judge) | 0.087 | 0.042 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".