Recent reviews suggest a low risk of allergic reactions to egg-cultured influenza virus vaccines
Australian influenza notification and hospitalisation rates are highest in children aged under 5 years,1 the group most commonly affected by egg allergy. While vaccines derived from influenza virus grown in mammalian cell cultures exist, those currently distributed in Australia and New Zealand are grown in hen eggs. The ability to safely vaccinate egg-allergic individuals (particularly in the context of epidemic influenza) will remain an important public health issue, well after concerns surrounding recent non-allergic adverse reactions in young children subside (Australian governments recently suspended seasonal flu vaccination for healthy children aged under 5 years; see http://www.immunise.health.gov.au).
- 1. Australian Government Department of Health and Ageing. Australian influenza surveillance report. No. 22, 2009, reporting period 3 October 2009 – 9 October 2009. http://www.health.gov.au/internet/main/publishing.nsf/Content/053B6E8C4D7741A9CA2575C8001C7334/$File/ozflu-no22-2009.pdf (accessed May 2010).
- 2. National Health and Medical Research Council. The Australian immunisation handbook. 9th ed. Canberra: Commonwealth of Australia, 2008. http://www.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook-home (accessed May 2010).
- 3. Moneret-Vautrin DA, Kanny G. Update on threshold doses of food allergens: implications for patients and the food industry. Curr Opin Allergy Clin Immunol 2004; 4: 215-219.
- 4. Erlewyn-Lajeunesse M, Brathwaite N, Lucas JS, Warner JO. Recommendations for the administration of influenza vaccine in children allergic to egg. BMJ 2009; 339: b3680.
- 5. Retailliau HF, Curtis AC, Storr G, et al. Illness after influenza vaccination reported through a nationwide surveillance system, 1976–1977. Am J Epidemiol 1980; 111: 270-278.
- 6. James JM, Zeiger RS, Lester MR, et al. Safe administration of influenza vaccine to patients with egg allergy. J Pediatr 1998; 133: 624-628.
- 7. Esposito S, Gasparini C, Martelli A, et al. Safe administration of an inactivated virosomal adjuvanted influenza vaccine in asthmatic children with egg allergy. Vaccine 2008; 26: 4664-4668.
- 8. Gagnon R, Primeau MN, Roches AD, et al; PHAC-CIHR Influenza Research Network (PCIRN). Safe vaccination of patients with egg allergy with an adjuvanted pandemic H1N1 vaccine. J Allergy Clin Immunol 2010; 126: 317-323.
- 9. Chan D, Loh R, Nolan R, et al. The safety of influenza vaccine in children with anaphylactic egg allergy — a pilot study [abstract]. Intern Med J 2009; 39 Suppl 5: A139. http://www3.interscience.wiley.com/cgi-bin/fulltext/122594040/PDFSTART (accessed Jul 2010).
- 10. Chung EY, Huang L, Schneider L. Safety of influenza vaccine administration in egg-allergic patients. Pediatrics 2010; 125: e1024-e1030.
- 11. EAACI (European Academy of Allergy and Clinical Immunology) recommendations for health professionals regarding seasonal and swine influenza vaccination in egg-allergic patients [press release]. 26 Oct 2009. Zurich: EAACI, 2009. http://www.eaaci.net/attachments/1282_091026_EAACI_Release_%20H1N1_Egg%20Allergy_pub%20-%20Health %20Professionals.pdf (accessed Apr 2010).
- 12. Kelso JM. Administration of influenza vaccines to patients with egg allergy. J Allergy Clin Immunol 2010; 125: 800-802.
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