Administration of influenza vaccines to patients with egg allergy

Administration of Yellow Fever Vaccine in Patients with Egg Allergy

“…In addition, as in the case of influenza vaccine, multiple-step desensitization should be compared with a 2-step protocol (10 + 90%). Data are emerging on the safe administration of influenza vaccine with an ovalbumin content much higher than YFV in egg-allergic subjects [28]. Therefore, it should be possible to administer Stamaril (Sanofi Pasteur) with a mean content of 0.105 μg/dose in a single dose without skin testing, but due to the small number of patients we have not been able to test this hypothesis.…”

Administration of influenza vaccines to patients with egg allergy: Update for the 2010-2011 season

“…1 In a recent editorial this author argued strongly for the administration of influenza vaccines to patients with egg allergy because the risk of not vaccinating far outweighs the risk of vaccinating. 2 None of the brands of influenza vaccine for the 2009-2010 season were shown to contain ovalbumin in excess of that found to be safe for administration to patients with egg allergy. 3,4 Although in theory it seems prudent to choose a brand with a lower amount of egg protein to reduce the chances of a reaction, 2 several recent publications have appeared that present additional considerations when choosing a particular influenza vaccine for a patient with egg allergy.…”

“…12 The vaccines with the highest amount of ovalbumin are Fluzone and Fluzone High-Dose (Sanofi Pasteur, Swiftwater, Pa). [2][3][4] The combined package insert for these vaccines 13 does not state the ovalbumin contents, but the manufacturer indicates that the ovalbumin content is less than 5 mg/0.5-mL dose for Fluzone and, because of differences in the manufacturing process, less than 1.6 mg/0.5-mL dose for Fluzone High-Dose (personal communication, October 2010).…”

“…Another possible choice is not vaccinating at all, but the risk of disease in unvaccinated persons would seem to far outweigh any risk of vaccination. 2 Many clinics and hospitals purchase influenza vaccine from only 1 or a limited number of manufacturers, which might further limit the choices of vaccine available.…”

Influenza Vaccine and Egg Allergy: Nearing the End of an Evidence-Based Journey

“…1 Numerous studies had been published that indicated that influenza vaccine could be safely administered to recipients with egg allergy 2 ; however, as recently as 2010, the notion that patients with egg allergy could be given the influenza vaccine as a single dose without prior vaccine skin testing was so controversial that a Clinical Pearls article in the Journal of Allergy and Clinical Immunology that proposed this had to be relabeled an Editorial. 3 There have now been a total of 28 studies published on this subject, in which, collectively, 4315 subjects with egg allergy, including 656 with histories of anaphylactic reactions to the ingestion of eggs, have received influenza vaccine with no serious reactions. 2 Such reassuring data led to a dramatic shift in recommendations from the Advisory Committee on Immunization Practices beginning in 2011, which indicated that patients with egg allergy who developed only hives with egg ingestion (the only reaction in the majority of such patients) should receive influenza vaccine in the usual manner and be observed for 30 minutes afterward, and that patients with more severe reactions to the ingestion of egg should be referred to an allergist for vaccination.…”