No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients
<p>Abstract</p> <p>Background</p> <p>There are numerous, disparate guidelines for influenza vaccination in egg-allergic patients. We aimed to describe the outcome of selectively applied guidelines, based on risk-stratification, to our high risk, egg-allergic, tertiary-c...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2012-03-01
|
| Series: | Allergy, Asthma & Clinical Immunology |
| Subjects: | |
| Online Access: | http://www.aacijournal.com/content/8/1/2 |
| _version_ | 1818370317607763968 |
|---|---|
| author | Upton Julia Hummel David Kasprzak Anna Atkinson Adelle |
| author_facet | Upton Julia Hummel David Kasprzak Anna Atkinson Adelle |
| author_sort | Upton Julia |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>There are numerous, disparate guidelines for influenza vaccination in egg-allergic patients. We aimed to describe the outcome of selectively applied guidelines, based on risk-stratification, to our high risk, egg-allergic, tertiary-care pediatric population.</p> <p>Methods</p> <p>Egg allergy was confirmed with skin testing. The vaccine administered was an adjuvunated 2009 H1N1 influenza A vaccine with < 0.165 mcg/ml ovalbumin. Patients with mild egg allergy were to receive the vaccination in 1 dose, those with severe egg allergy were to receive 2 split doses, and patients with exquisite egg allergy or significant co-morbidities were to be skin tested with the vaccine (prick full strength, intradermal 1:100 of final concentration without adjuvant) and had 5 step desensitization if the testing was positive, or 1-2 step administration if negative. Patients were observed for 60 minutes after the final dose and anaphylaxis treatment was available. We report the frequency of allergic reactions.</p> <p>Results</p> <p>Ninety-nine patients were referred and 79 had positive egg testing. Asthma was present in 67% and 30% had prior anaphylaxis to egg. We vaccinated 77 of 79 patients: 71 without performing vaccine skin testing. Two refused vaccination. No patient had a systemic reaction or required treatment. Two patients experienced positive testing to the adjuvanated intradermal vaccine, but were negative without adjuvant.</p> <p>Conclusions</p> <p>Our results suggest that most egg-allergic tertiary care pediatric patients can be vaccinated with a low ovalbumin content influenza vaccine without prior vaccine testing. Vaccine skin testing, if used at all, can be reserved for special circumstances. The squalene adjuvant may cause an irritant reaction with intradermal testing.</p> |
| first_indexed | 2024-12-13T23:37:49Z |
| format | Article |
| id | doaj.art-2943abf288274f38ae13141a494546ee |
| institution | Directory Open Access Journal |
| issn | 1710-1484 1710-1492 |
| language | English |
| last_indexed | 2024-12-13T23:37:49Z |
| publishDate | 2012-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Allergy, Asthma & Clinical Immunology |
| spelling | doaj.art-2943abf288274f38ae13141a494546ee2022-12-21T23:27:15ZengBMCAllergy, Asthma & Clinical Immunology1710-14841710-14922012-03-0181210.1186/1710-1492-8-2No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patientsUpton JuliaHummel DavidKasprzak AnnaAtkinson Adelle<p>Abstract</p> <p>Background</p> <p>There are numerous, disparate guidelines for influenza vaccination in egg-allergic patients. We aimed to describe the outcome of selectively applied guidelines, based on risk-stratification, to our high risk, egg-allergic, tertiary-care pediatric population.</p> <p>Methods</p> <p>Egg allergy was confirmed with skin testing. The vaccine administered was an adjuvunated 2009 H1N1 influenza A vaccine with < 0.165 mcg/ml ovalbumin. Patients with mild egg allergy were to receive the vaccination in 1 dose, those with severe egg allergy were to receive 2 split doses, and patients with exquisite egg allergy or significant co-morbidities were to be skin tested with the vaccine (prick full strength, intradermal 1:100 of final concentration without adjuvant) and had 5 step desensitization if the testing was positive, or 1-2 step administration if negative. Patients were observed for 60 minutes after the final dose and anaphylaxis treatment was available. We report the frequency of allergic reactions.</p> <p>Results</p> <p>Ninety-nine patients were referred and 79 had positive egg testing. Asthma was present in 67% and 30% had prior anaphylaxis to egg. We vaccinated 77 of 79 patients: 71 without performing vaccine skin testing. Two refused vaccination. No patient had a systemic reaction or required treatment. Two patients experienced positive testing to the adjuvanated intradermal vaccine, but were negative without adjuvant.</p> <p>Conclusions</p> <p>Our results suggest that most egg-allergic tertiary care pediatric patients can be vaccinated with a low ovalbumin content influenza vaccine without prior vaccine testing. Vaccine skin testing, if used at all, can be reserved for special circumstances. The squalene adjuvant may cause an irritant reaction with intradermal testing.</p>http://www.aacijournal.com/content/8/1/2egg allergyvaccinationinfluenza virusadjuvantsqualene |
| spellingShingle | Upton Julia Hummel David Kasprzak Anna Atkinson Adelle No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients Allergy, Asthma & Clinical Immunology egg allergy vaccination influenza virus adjuvant squalene |
| title | No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients |
| title_full | No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients |
| title_fullStr | No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients |
| title_full_unstemmed | No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients |
| title_short | No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients |
| title_sort | no systemic reactions to influenza vaccination in egg sensitized tertiary care pediatric patients |
| topic | egg allergy vaccination influenza virus adjuvant squalene |
| url | http://www.aacijournal.com/content/8/1/2 |
| work_keys_str_mv | AT uptonjulia nosystemicreactionstoinfluenzavaccinationineggsensitizedtertiarycarepediatricpatients AT hummeldavid nosystemicreactionstoinfluenzavaccinationineggsensitizedtertiarycarepediatricpatients AT kasprzakanna nosystemicreactionstoinfluenzavaccinationineggsensitizedtertiarycarepediatricpatients AT atkinsonadelle nosystemicreactionstoinfluenzavaccinationineggsensitizedtertiarycarepediatricpatients |