Safety of Inactivated Influenza Vaccine in Patients with Egg Allergy in Kurdistan Province, Iran
Background: Most influenza vaccines are grown in embryonated eggs and residual egg proteins can cause allergic reactions in patients with egg allergy. The aim of the present study was to determine the safety of inactivated influenza vaccine in patients with egg allergy in Kurdistan Province, Iran.
Methods: This case-control study was done on 876 patients referred to Kurdistan Asthma and Allergy Clinic, Sanandaj, Iran; 635 patients with egg allergy (cases) and 241 patients without egg allergy (controls) from 2012 to 2016. All of the patients were injected seasonal influenza vaccine. Side effects including anaphylactic shock, local reaction, vomiting, coughing, sneezing, wheezing, low blood pressure, redness and itching in the eyes, abdominal pain, dyspnea, oral/facial angioedema, swollen and itching of throat were checked by an allergist within 30 min after vaccination, and followed up to 24 h. Demographic and vaccination data were entered into the SPSS software and analyzed.
Results: Out of 876 patients, 460 (52.5%) were male. Patients' ages ranged from 6 months to 80 yr (mean 13.38 ± 15.22 SD). Overall, 63 patients with egg allergy had local reactions to vaccine. Difference of local reactions between case and control groups was statistically significant (P=0.001). No anaphylactic reactions were seen after vaccination.
Conclusion: Although the risk of anaphylactic reactions to influenza vaccine in patients with egg allergy was rare, the vaccine should be administered by an allergist with precaution. The results of present study can be a confirmation of the existing evidences to prevent acute complications to influenza vaccine.
2. Croegaert KA, Ithman MM, Spurgin AL et al (2013). Influenza vaccine safety in patients with egg allergy. J Am Pharm Assoc, 53(2):214-6.
3. Turner PJ, Southern J, Andrews NJ et al (2015). Safety of live attenuated influenza vaccine in atopic children with egg allergy. J Allergy Clin Immunol, 136(2):376-81.
4. Pitt T, Kalicinsky C, Warrington R et al (2011). Assessment of epicutaneous testing of a monovalent Influenza A (H1N1) 2009 vaccine in egg allergic patients. Allergy Asthma Clin Immunol, 7(1):3.
5. Grohskopf LA, Sokolow LZ, Broder KR et al (2016). Prevention and Control of Seasonal Influenza with Vaccines. MMWR Recomm Rep, 65(5):1-54.
6. Taubenberger JK, Morens DM (2008). The pathology of influenza virus infections. Annu Rev Pathol, 3:499-522.
7. Greenhawt MJ, Spergel JM, Rank MA et al (2012). Safe administration of the seasonal trivalent influenza vaccine to children with severe egg allergy. Ann Allergy Asthma Immunol, 109(6):426-30.
8. Greenhawt MJ (2013). Establishing the safety of influenza vaccine in egg-allergic individuals. Pediatr Ann, 42(7):122-7.
9. Forsdahl BA (2012). Reactions of Norwegian children with severe egg allergy to an egg-containing influenza A (H1N1) vaccine: a retrospective audit. BMJ Open, 2:e000186.
10. Schuler JE, King WJ, Dayneka NL et al (2011). Administration of the adjuvanted pH1N1 vaccine in egg-allergic children at high risk for influenza A/H1N1 disease. Can J Public Health, 102(3):196-9.
11. Izikson R, Leffell DJ, Bock SA et al (2015). Randomized comparison of the safety of Flublok((R)) versus licensed inactivated influenza vaccine in healthy, medically stable adults >/= 50 yr of age. Vaccine, 33(48):6622-8.
12. Kelso JM (2015). Influenza vaccine and egg allergy: nearing the end of an evidence-based journey. J Allergy Clin Immunol Pract, 3(1):140-1.
13. McNeil MM, Weintraub ES, Duffy J et al (2016). Risk of anaphylaxis after vaccination in children and adults. J Allergy Clin Immunol, 137(3):868-78.
14. Woo EJ (2015). Allergic reactions after egg-free recombinant influenza vaccine: reports to the US Vaccine Adverse Event Reporting System. Clin Infect Dis, 60(5):777-80.
15. Li JT, Rank MA, Squillace DL, Kita H (2010). Ovalbumin content of influenza vaccines. J Allergy Clin Immunol, 125(6):1412-3; author reply 3-4.
16. Des Roches A, Paradis L (2016). Influenza vaccination and egg allergy: another step forward. Evid Based Med, 21(3):113.
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