no systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients没有接种流感疫苗的系统性反应egg-sensitized三级护理小儿患者.pdfVIP

Upton et al. Allergy, Asthma Clinical Immunology 2012, 8:2 /content/8/1/2 ALLERGY, ASTHMA CLINICAL IMMUNOLOGY RESEARCH Open Access No systemic reactions to influenza vaccination in egg-sensitized tertiary-care pediatric patients * Julia Elizabeth Mainwaring Upton , David Brian Hummel, Anna Kasprzak and Adelle Roberta Atkinson Abstract Background: There are numerous, disparate guidelines for influenza vaccination in egg-allergic patients. We aimed to describe the outcome of selectively applied guidelines, based on risk-stratification, to our high risk, egg-allergic, tertiary-care pediatric population. Methods: Egg allergy was confirmed with skin testing. The vaccine administered was an adjuvunated 2009 H1N1 influenza A vaccine with 0.165 mcg/ml ovalbumin. Patients with mild egg allergy were to receive the vaccination in 1 dose, those with severe egg allergy were to receive 2 split doses, and patients with exquisite egg allergy or significant co-morbidities were to be skin tested with the vaccine (prick full strength, intradermal 1:100 of final concentration without adjuvant) and had 5 step desensitization if the testing was positive, or 1-2 step administration if negative. Patients were observed for 60 minutes after the final dose and anaphylaxis treatment was available. We report the frequency of allergic reactions. Results: Ninety-nine patients were referred and 79 had positive egg testing. Asthma was present in 67% and 30% had prior anaphylaxis to egg. We vaccinated 77 of 79 patients: 71 without performing vaccine skin testing. Two refused vaccination. No patient had a systemic reaction or requi