The safety of the H1N1 influenza A vaccine in egg allergic individuals
The safety of the H1N1 influenza A vaccine in egg allergic individuals
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DOI：
10.1016/j.anai.2010.08.015
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发表时间：
2010-11-01
影响因子：
5.9
通讯作者：
Sanders, Georgiana
中科院分区：
文献类型：
--
作者：
Greenhawt, Matthew J.;Chernin, Anna S.;Sanders, Georgiana
背景：H1N1疫苗在鸡蛋过敏(EA)患者中的安全性尚不清楚。目的：确定接种H1N1疫苗的安全性，并评估EA患者H1N1皮试的可预测性。方法：在一项对照、前瞻性试验中，比较了EA患者(n=105)和非EA对照组(n=19)的H1N1皮试和疫苗接种情况。H1N1皮试结果为阴性的患者接受了全剂量的H1N1疫苗；皮试结果为阳性的患者接受了分级挑战(10%-90%)。结果：124名受试者中有3名(2.4%)皮试阳性，而124名研究参与者中有41名(33.1%)皮内试验阳性。41人接受了分两步分级的疫苗挑战，其中包括25名有鸡蛋过敏史的人中的13人。无论是接种方法还是随后的加强剂量都没有引起明显的过敏反应。结论：所有研究参与者都接种了H1N1疫苗，没有明显的过敏反应。皮肤测试是不必要的，也不能预测疫苗的耐受性。所有接受分级挑战的研究参与者都耐受来自不同的、未经测试的批次的单剂增强剂，其中包括7名有鸡蛋过敏史的人。我们建议EA儿童在没有事先进行皮肤测试或分级挑战剂量的情况下接种H1N1疫苗。过敏性哮喘免疫。2010；105：387-393。
Background: The safety of H1N1 vaccine is unknown in egg allergic (EA) recipients.Objectives: To establish the safety of administering H1N1 vaccine and to evaluate the predictability of H1N1 skin testing in EA patients.Methods: In a controlled, prospective trial, H1N1 skin testing and vaccination was compared between EA patients (n = 105) and non-EA controls (n = 19). Those with negative H1N1 skin test results received a full H1N1 dose; those with a positive skin test result received a graded challenge (10%, 90%). Booster vaccine, if required, was given as a single dose from a different lot without prior testing.Results: Prick and intradermal test results were positive in 3 (2.4%) of 124 and 41 (33.1%) of 124 study participants, respectively. Forty-one individuals received a 2-step graded vaccine challenge, including 13 of 25 with a history of egg anaphylaxis. No significant allergic reactions resulted from either method of vaccination or from subsequent booster doses.Conclusion: All study participants received the H1N1 vaccine without significant allergic reactions. Skin testing is unnecessary and does not predict vaccine tolerance. All study participants who received a graded challenge tolerated a single dose booster from a different, untested lot, including 7 individuals with a history of egg-induced anaphylaxis. We recommend administration of H1N1 vaccine to EA children without prior skin testing or graded challenge dosing. Ann Allergy Asthma Immunol. 2010;105:387-393.