Bee sting vaccine now available

About one in 200 people suffer from anaphylaxis when stung by a wasp or bee.

Every year between two and nine people die after going into anaphylatic shock – the most extreme form of anaphylaxis – as a result of being stung.

Contrary to popular belief, wasp stings actually cause twice as many deaths due to anaphylaxis as bee stings.

Now the National Institute for Health and Clinical Excellence (Nice), which decides on whether treatments can be prescribed on the NHS in England and Wales, has indicated it will approve a product called Pharmalgen.

Given in a series of injections, this works by gradually introducing higher doses of the allergens in bee and wasp venom. Over time, this desensitises a person by gently stimulating their immune system.

Treatment is carried out in two phases: the initial phase and the maintenance phase, which lasts three years.

Anaphylactic reactions are when the immune system responds inappropriately to an allergen, releasing large quantities of chemicals called histamines, that cause blood capillaries to dilate and blood pressure to drop. In extreme cases airways can collapse and the heart can fail.

In draft guidance that is highly likely to be confirmed early next year, Nice announced it was recommending Pharmalgen for people who had experienced “a severe systemic reaction to bee or wasp venom”.

Bee stings

Bee stings

Nice also recommended it for those who had experienced a “moderate systemic reaction” and were also at “a high risk of future stings”, had a raised level of a blood serum known to indicate anaphylaxis, or were “anxious about future stings”.

Professor Peter Littlejohns, clinical and public health director at Nice said: “The reactions that some people experience to stings from bees and wasps can be distressing, frightening and sometimes life-threatening.

“People who have had a serious reaction to a sting can often experience extreme anxiety about possible future stings, and this can affect their daily lives.

“So we are pleased to be able to recommend Pharmalgen as an effective, preventative treatment in preliminary recommendations issued today.”

Pharmalgen is the first preventative medicine for bee and wasp stings that Nice has recommended for approval.

Anaphylaxis can be effectively controlled by quickly administering adrenaline by injection. This constricts blood vessels, relaxes muscles in the lungs to aid breathing, stimlulates the heart to beat properly and stops facial swelling.

However, sometimes it cannot be given quickly enough. Last October farmer John Croall, 52, died after being stung while herding sheep in a remote field near Balkeerie, Angus. Ambulance crews were unable to reach him soon enough and the father-of-three died after suffering anaphylactic shock.

Moira Austin, of the Anaphylaxis Campaign, welcomed Nice’s decision to approve it.


She said: “The Anaphylaxis Campaign has been participating as a patient/carer consultee in the Pharmalgen appraisal, representing those living with severe allergy to bee or wasp venom.

“We have spoken with many individuals who have been successfully treated with Pharmalgen and who have, as a result, experienced a significant improvement in their quality of life.

“We are delighted with the appraisal committee’s preliminary recommendations and look forward to their final recommendations.“

There could be some eyebrows raised about the cost of providing the treatment. Nice usually sets a ceiling of £30,000 per ‘quality adjusted life year’ (QALY) that a medication brings.

Its appraisal committee modelled the cost at £13,800 per QALY, but this was based on a course of Pharmalgen remaining effective for 20 years, for which members admitted there was no evidence.

The committee also said the cost assumption was highly sensitive to the number of stings a person might receive: the fewer, the less cost-effective it was.

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