WASHINGTON — Among 349 pediatric patients with egg allergy who received the influenza vaccine under a graded-dose protocol, 96% had no reaction, according to a retrospective study.
These patients “can safely receive the influenza vaccine based on the graded-dose protocol under appropriate medical supervision,” researchers from the Children's Hospital of Philadelphia reported in a poster presentation at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
A history of egg allergy has traditionally been a contraindication for flu vaccine, because the viruses in the vaccine are grown in chicken eggs
The study included 349 patients with egg allergy who received influenza vaccine in 2007. Egg allergy was confirmed with skin testing or oral challenge, and all patients were given skin tests to full-strength influenza vaccine. The 58 patients with positive skin tests to influenza underwent desensitization with graded vaccination doses (patients under 36 months of age: 0.05 mL, 0.1 mL, and 0.1 mL; patients 36 months and older: 0.05 mL, 0.1 mL, 0.15 mL, and 0.2 mL).
Among these 58 patients, there were no cases of anaphylaxis, and Dr. Rushani Saltzman and her associates reported that there was no need for epinephrine administration in any case.
There were eight cases of urticaria, four cases of local erythema at the injection site, two cases of atopic dermatitis flare, and one case of urticaria-related wheezing. All reactions were mild.
“No reactions were noted in the 43 remaining influenza skin test-positive patients,” noted the authors.