Higher-ovalbumin-content influenza vaccines are well tolerated in children with egg allergy.
Higher-ovalbumin-content influenza vaccines are well tolerated in children with egg allergy.
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鸡蛋过敏的儿童对卵清蛋白含量较高的流感疫苗具有良好的耐受性。
DOI：
10.1016/j.jaci.2010.10.005
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
A. MacGinnitie
中科院分区：
文献类型：
--
作者：
G. Owens;A. MacGinnitie
对 2009 年 10 月期间在美国过敏/免疫诊所接种季节性流感疫苗、H1N1 流感疫苗或两者兼而有之的鸡蛋过敏患者进行了回顾性图表审查。所有在此期间接受流感疫苗的已知鸡蛋过敏患者均使用两步方案进行评估。在接种疫苗之前获得书面同意。鸡蛋过敏被定义为具有鸡蛋反应的临床病史，且鸡蛋特异性 IgE 测量结果呈阳性，或者 SPT 结果呈阳性，或者测试结果呈阳性（SPT 或鸡蛋特异性 IgE 测量），但没有鸡蛋食用史。目前直接食用鸡蛋的患者被排除在本研究之外，因为他们不被认为患有鸡蛋过敏。疫苗方案以两步方案提供流感疫苗，首先以 10% 等分试样形式提供，然后以剩余 90% 的形式提供，在剂量之间和最终剂量之后有 15 至 30 分钟的观察期。我们诊所专门使用赛诺菲巴斯德季节性（Fluzone）和HlN1流感疫苗进行疫苗接种。观察所有患者的局部（注射部位红斑）和全身（荨麻疹、喘息和呕吐）反应的迹象，如果他们有任何这些客观症状，则被认为有过敏反应。 64 名患者和 96 次疫苗接种中出现 4 例轻度过敏反应，患者反应率分别为 6.2%（95% CI，4.4% 至 7.8%）和疫苗接种者的 4.2%（95% CI，3.4% 至 5.0%）。没有患者出现过敏反应，因为所有反应都是荨麻疹或红斑的轻微皮肤症状。对疫苗接种有反应和没有反应的患者之间没有显着差异。有反应的患者的平均卵子特异性 IgE 水平高于无反应的患者，但这并未达到统计学显着性，并且是由一名卵子特异性 IgE 水平大于 100 kUA/升的反应患者造成的。 2 名患者对季节性疫苗有反应，1 名患者对 H1N1 疫苗有反应，1 名患者在同时接种两种疫苗时有反应。 4 名出现反应的患者中，有 3 名能够耐受烘焙食品中的鸡蛋，4 名患者中的 3 名对 10% 剂量有反应（其余 90% 剂量对这些患者不予服用）。这些数据进一步证明，当以 10%/90% 方案给予鸡蛋过敏患者时，流感疫苗具有良好的耐受性。需要进一步的研究来评估是否有必要采取两步方案，或者鸡蛋过敏的患者是否可以接受单剂流感疫苗。
A retrospective chart review was carried out among patients with egg allergy who received the influenza vaccine, either seasonal, H1N1, or both, in an allergy/immunology clinic during, in the USA during 2009-10. All known patients with egg allergy who received an influenza vaccine during that time were evaluated using a 2-step protocol. Written consent was obtained before vaccine administration. Egg allergy was defined as having a clinical history of egg reaction with confirmatory positive results on either egg- specific IgE measurement or positive SPT results or positive test results (SPT or egg-specific IgE measurement) without a history of egg consumption. Patients currently consuming egg directly were excluded from this study because they were not considered to have egg allergy. The vaccine protocol provided the influenza vaccine in a 2-step protocol first as a 10% aliquot and then the remaining 90% with a 15- to 30-minute observation period between doses and after the final dose. The Sanofi-Pasteur seasonal (Fluzone) and HlNl influenza vaccine were exclusively used in our clinic for vaccination. All patients were observed for signs of both local (injection-site erythema) and systemic (hives, wheezing, and vomiting) reactions and were considered to have an allergic reaction if they had any of these objective symptoms. Four mild allergic reactions occurred among 64 patients and 96 total vaccinations, resulting in a reaction rate of 6.2% of patients (95% CI, 4.4% to 7.8%) and 4.2% of vaccinations (95% CI, 3.4% to 5.0%), respectively. No patients had anaphylaxis as all reactions were mild cutaneous symptoms of urticaria or erythema. There were no significant differences between patients who did and did not react to vaccination. The average egg-specific IgE levels were higher in patients who reacted than in those who did not, but this did not reach statistical significance and was driven by one reacting patient with an egg-specific IgE level of greater than 100 kUA/litre. Two patients reacted to the seasonal vaccine, 1 reacted to the H1N1 vaccine, and 1 reacted when both were administered simultaneously. Three of 4 of the patients with reactions tolerated egg in baked goods, and 3 of 4 reacted to the 10% dose (the remaining 90% dose was withheld from these patients). These data further support that the influenza vaccine is well tolerated when given in a l0%/90% protocol to patients with egg allergy. Further research is needed to evaluate whether a 2-step protocol is necessary or whether patients with egg allergy can receive the influenza vaccine in a single dose.
流感疫苗的卵清蛋白含量。
DOI：
10.1016/j.jaci.2010.03.009
发表时间：
2010
期刊：
The Journal of allergy and clinical immunology
影响因子：
--
作者：
Li,JamesT;Rank,MatthewA;Squillace,DianeL;Kita,Hirohito
通讯作者：
Kita,Hirohito