SAFE ADMINISTRATION OF INFLUENZA VACCINE TO PATIENTS WITH EGG ALLERGY

Objectives: Specific recommendations for administering the influenza v accine to patients with egg allergy are based on limited scientific da ta. The objectives of this investigation were to determine the safety of a 2-dose administration of an influenza vaccine to patients with eg g allergy and to evaluate the usefulness of skin testing with the infl uenza vaccine before administration. Study design: In this multicenter clinical trial, clinical histories of egg allergy were confirmed by s kin testing with egg and, if possible, by oral challenges with egg. Su bjects with egg allergy received the vaccine in 2 doses, 30 minutes ap art; the first dose was one tenth and the second dose nine tenths of t he recommended dose as determined by age. Subjects without egg allergy were recruited as control subjects and received 1 age-determined dose of the vaccine. Skin pride tests with the influenza vaccine were perf ormed on all subjects. Results: From 1994 to 1997, 83 subjects with eg g allergy and 124 control subjects were evaluated. The content of oval bumin/ovomucoid was 0.1, 1.2, and 0.02 mu g/mL, respectively in the 19 94-95, 1995-96, and 1996-97 influenza vaccines. Results of vaccine ski n prick tests were positive in 4 subjects with egg allergy and in 1 co ntrol subject. All patients with egg allergy tolerated the vaccination protocol without any significant allergic reactions. Conclusions: The se results demonstrate that patients with egg allergy, even those with significant allergic reactions after egg ingestion, can safely receiv e an influenza vaccine in a 2-dose protocol when the vaccine preparati on contains no more than 1.2 mu g/mL egg protein.