Safety of live attenuated influenza vaccine in atopic children with egg allergy

Started by guess, February 28, 2015, 09:29:23 AM

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QuoteBackgroundLive attenuated influenza vaccine (LAIV) is an intranasal vaccine recently incorporated into the United Kingdom immunization schedule. However, it contains egg protein and, in the absence of safety data, is contraindicated in patients with egg allergy. Furthermore, North American guidelines recommend against its use in asthmatic children.[/font][/size][/font][/q]
ObjectiveWe sought to assess the safety of LAIV in children with egg allergy.[/font]
MethodsWe performed a prospective, multicenter, open-label, phase IV intervention study involving 11 secondary/tertiary centers in the United Kingdom. Children with egg allergy (defined as a convincing clinical reaction to egg within the past 12 months and/or >95% likelihood of clinical egg allergy as per published criteria) were recruited. LAIV was administered under medical supervision, with observation for 1 hour and telephone follow-up 72 hours later.[/font]
ResultsFour hundred thirty-three doses were administered to 282 children with egg allergy (median, 4.9 years; range, 2-17 years); 115 (41%) had experienced prior anaphylaxis to egg. A physician's diagnosis of asthma/recurrent wheezing was noted in 67%, and 51% were receiving regular preventer therapy. There were no systemic allergic reactions (upper 95% CI for population, 1.3%). Eight children experienced mild self-limiting symptoms, which might have been due an IgE-mediated allergic reaction. Twenty-six (9.4%; 95% CI for population, 6.2% to 13.4%) children experienced lower respiratory tract symptoms within 72 hours, including 13 with parent-reported wheeze. None of these episodes required medical intervention beyond routine treatment.[/font]
ConclusionsIn contrast to current recommendations, LAIV appears to be safe for use in children with egg allergy. Furthermore, the vaccine appears to be well tolerated in children with a diagnosis of asthma or recurrent wheeze.[/font]


DD was diagnosed with asthma this week. 

Luckily, our new children's hospital houses pulmonology and allergy in the same office.  So her new pulmonologist pulled in her allergist and we talked about the flu vaccine.  I've been very hesitant due to non-localized contact reactions within the last year.  Did a scratch test, which was negative for a reaction.  She tolerated the injection well.

There is a totally egg-free option, but it's not as successful/immunologic.  Sorry, the exact wording slips my mind as I was woefully underslept. 

I know kids hate the scratch tests, but it eased my mind going into it.  And the pulmonologist and allergist both supported that route given her history of egg reactions.

DS (04/07) eggs (baked okay now!)
DD (03/12) eggs (small dose baked), stevia
DH histamine intolerance
Me?  Some days it seems like everything.


The egg-free vaccine has not been approved for people under age 18. I was just talking about that during DD's tree nut challenge.

DD has had the flu vaccine successfully for several years. Though we do have to argue with her pediatrician's office about administering the vaccine every year.
"Oh, I'm such an unholy mess of a girl."

DD allergic to peanuts, tree nuts, and egg; OAS to cantaloupe and cucumber

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