Dataset Information

Reactions of Norwegian children with severe egg allergy to an egg-containing influenza A (H1N1) vaccine: a retrospective audit.

ABSTRACT: Design Retrospective audit. Setting Secondary paediatric outpatient clinic, Tromsø, Norway. Participants The participants were 80 (62.5% boys and 37.5% girls) children and adolescents with a diagnosed egg allergy who had to be on an egg-free diet and be unable to eat any food containing any amount of egg, including egg-containing baked goods, without an allergic reaction to egg protein. We also included patients who were sensitised to egg but had never been exposed to egg or egg-containing baked goods and were on an egg-free diet. Other atopic diseases among the study participants were also registered. Intervention The vaccination took place from November to December 2009. The patients were vaccinated with a monovalent influenza A (H1N1) vaccine that had an ovalbumin content <0.33 ?g/ml. They were divided into two groups, receiving the vaccine either as a single dose or as a fractionated dose. Patients were selected for the fractionated dose because of their prior reaction to egg or because they never had been exposed to egg. Primary outcome There were no serious adverse reactions to the vaccine; only one mild adverse reaction and two possible adverse reactions. Results Patients ranged in age from 10 months to 16.5 years. Thirty-eight (48%) patients received a fractionated dose. Sixty-three (79%) had one or more atopic disease apart from egg allergy. With regard to atopy, serum specific IgE levels or skin prick test, there were no significant differences between the groups receiving the vaccine as a fractionated or as a single dose. Conclusions The study confirmed that patients allergic to egg can be safely vaccinated with a regular influenza vaccine containing <0.333 ?g/ml ovalbumin, even if these patients had displayed previous anaphylactic reactions to egg and had been diagnosed with concurrent atopic diseases.

SUBMITTER: Forsdahl BA

PROVIDER: S-EPMC3253424 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Reactions of Norwegian children with severe egg allergy to an egg-containing influenza A (H1N1) vaccine: a retrospective audit.

Forsdahl Bård Anders BA

BMJ open 20120105

Design Retrospective audit. Setting Secondary paediatric outpatient clinic, Tromsø, Norway. Participants The participants were 80 (62.5% boys and 37.5% girls) children and adolescents with a diagnosed egg allergy who had to be on an egg-free diet and be unable to eat any food containing any amount of egg, including egg-containing baked goods, without an allergic reaction to egg protein. We also included patients who were sensitised to egg but had never been exposed to egg or egg-containing bak ...[more]

PMID: 22223837

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Project description:Study questionHow safe is live attenuated influenza vaccine (LAIV), which contains egg protein, in young people with egg allergy?MethodsIn this open label, phase IV intervention study, 779 young people (2-18 years) with egg allergy were recruited from 30 UK allergy centres and immunised with LAIV. The cohort included 270 (34.7%) young people with previous anaphylaxis to egg, of whom 157 (20.1%) had experienced respiratory and/or cardiovascular symptoms. 445 (57.1%) had doctor diagnosed asthma or recurrent wheeze. Participants were observed for at least 30 minutes after vaccination and followed-up by telephone 72 hours later. Participants with a history of recurrent wheeze or asthma underwent further follow-up four weeks later. The main outcome measure was incidence of an adverse event within two hours of vaccination in young people with egg allergy.Study answer and limitationsNo systemic allergic reactions occurred (upper 95% confidence interval for population 0.47% and in participants with anaphylaxis to egg 1.36%). Nine participants (1.2%, 95% CI 0.5% to 2.2%) experienced mild symptoms, potentially consistent with a local, IgE mediated allergic reaction. Delayed events potentially related to the vaccine were reported in 221 participants. 62 participants (8.1%, 95% CI for population 6.3% to 10.3%) experienced lower respiratory tract symptoms within 72 hours, including 29 with parent reported wheeze. No participants were admitted to hospital. No increase in lower respiratory tract symptoms occurred in the four weeks after vaccination (assessed with asthma control test). The study cohort may represent young people with more severe allergy requiring specialist input, since they were recruited from secondary and tertiary allergy centres.What this study addsLAIV is associated with a low risk of systemic allergic reactions in young people with egg allergy. The vaccine seems to be well tolerated in those with well controlled asthma or recurrent wheeze.Funding, competing interests, data sharingThis report is independent research commissioned and funded by a Department of Health policy research programme grant to the National Vaccine Evaluation Consortium. Additional funding was provided by the NIHR Clinical Research Networks, Health Protection Scotland (Edinburgh site), and Health & Social Care Services in Northern Ireland (Belfast site). PJT and MEL had support from the Department of Health for the submitted work; PJT has received research grants from the Medical Research Council and NIHR. No additional data available.Study registration ClinicalTrials.gov (NCT02111512) and the EU Clinical Trials Register EudraCT (2014-001537-92).

Dataset Information

Reactions of Norwegian children with severe egg allergy to an egg-containing influenza A (H1N1) vaccine: a retrospective audit.

Publications

Reactions of Norwegian children with severe egg allergy to an egg-containing influenza A (H1N1) vaccine: a retrospective audit.

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