Safety of Influenza Vaccine Administration in Egg-Allergic Patients
Safety of Influenza Vaccine Administration in Egg-Allergic Patients
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DOI：
10.1542/peds.2009-2512
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发表时间：
2010-05-01
期刊：
影响因子：
8
通讯作者：
Schneider, Lynda
中科院分区：
文献类型：
--
作者：
Chung, Erica Y.;Huang, Lin;Schneider, Lynda
目的：目前的指南建议鸡蛋过敏患者在接种流感疫苗前接受流感疫苗皮肤试验。本研究评估了对鸡蛋过敏的儿童不进行皮肤试验和注射分级剂量流感疫苗的安全性。方法：我们对6个月至18岁接受疫苗皮肤试验和/或2剂分级流感疫苗的鸡蛋过敏患者进行了回顾性图表回顾研究。在2002-2003年和2006-2007年流感季节期间，鸡蛋过敏患者在接种流感疫苗之前接受了疫苗皮肤试验。从2006-2007年开始，皮肤试验从我们的方案中删除，鸡蛋过敏患者接受了2次分级剂量的流感疫苗。观察所有接种疫苗的患者的不良反应。结果：261例鸡蛋过敏患者接受流感疫苗接种评估，171例继续接受疫苗接种。在接种流感疫苗前接受皮肤试验的56例患者中，95%（确切95%置信区间[CI]: 85.1-98.9）对疫苗耐受，未出现严重不良反应。从方案中删除疫苗皮肤试验后，这一比率没有变化。在没有事先进行皮肤试验而接种疫苗的115例患者中，97%（确切95% CI: 91.3-99.0）对疫苗耐受，无严重不良反应。容忍率比为1.01 （95% CI: 0.97-1.06）。结论：我们的研究结果表明，对鸡蛋没有过敏反应的鸡蛋过敏患者可以安全地接受2剂，分级方式的流感疫苗，而无需疫苗皮肤试验。儿科2010;125: e1024-e1030
OBJECTIVE: Current guidelines recommend that egg-allergic patients receive an influenza vaccine skin test before the influenza vaccine. This study evaluated the safety of bypassing the skin test and administering graded doses of influenza vaccine to egg-allergic children. METHODS: We conducted a retrospective chart-review study of egg-allergic patients aged 6 months to 18 years who received the vaccine skin test and/or a 2-dose graded influenza vaccine. Between influenza seasons 2002-2003 and 2006-2007, egg-allergic patients underwent a vaccine skin test before influenza vaccine administration. Starting in 2006-2007, the skin test was removed from our protocol and egg-allergic patients received the influenza vaccine in 2 graded doses. All vaccinated patients were observed for adverse reactions. RESULTS: Two hundred sixty-one egg-allergic patients were evaluated for influenza vaccine administration, and 171 went on to receive the vaccine. Of the 56 patients who received the skin test before the influenza vaccine, 95% ( exact 95% confidence interval [CI]: 85.1-98.9) tolerated the vaccine without a serious adverse reaction. This rate was unchanged after the vaccine skin test was removed from the protocol. Of the 115 patients who received the vaccine without a preceding skin test, 97% ( exact 95% CI: 91.3-99.0) tolerated the vaccine without serious adverse reaction. The tolerance rate ratio was 1.01 ( 95% CI: 0.97-1.06). CONCLUSION: The results of our study suggest that egg-allergic patients without anaphylaxis to egg may safely receive the influenza vaccine in a 2-dose, graded fashion without a vaccine skin test. Pediatrics 2010; 125: e1024-e1030