Forsdahl Bård Anders
Department of Pediatrics, University Hospital of North Norway, Tromsø, Norway.
BMJ Open. 2012 Jan 5;2(1):e000186. doi: 10.1136/bmjopen-2011-000186. Print 2012.
Design Retrospective audit. Setting Secondary paediatric outpatient clinic, Tromsø, Norway. Participants The participants were 80 (62.5% boys and 37.5% girls) children and adolescents with a diagnosed egg allergy who had to be on an egg-free diet and be unable to eat any food containing any amount of egg, including egg-containing baked goods, without an allergic reaction to egg protein. We also included patients who were sensitised to egg but had never been exposed to egg or egg-containing baked goods and were on an egg-free diet. Other atopic diseases among the study participants were also registered. Intervention The vaccination took place from November to December 2009. The patients were vaccinated with a monovalent influenza A (H1N1) vaccine that had an ovalbumin content <0.33 μg/ml. They were divided into two groups, receiving the vaccine either as a single dose or as a fractionated dose. Patients were selected for the fractionated dose because of their prior reaction to egg or because they never had been exposed to egg. Primary outcome There were no serious adverse reactions to the vaccine; only one mild adverse reaction and two possible adverse reactions. Results Patients ranged in age from 10 months to 16.5 years. Thirty-eight (48%) patients received a fractionated dose. Sixty-three (79%) had one or more atopic disease apart from egg allergy. With regard to atopy, serum specific IgE levels or skin prick test, there were no significant differences between the groups receiving the vaccine as a fractionated or as a single dose. Conclusions The study confirmed that patients allergic to egg can be safely vaccinated with a regular influenza vaccine containing <0.333 μg/ml ovalbumin, even if these patients had displayed previous anaphylactic reactions to egg and had been diagnosed with concurrent atopic diseases.
回顾性审计。地点:挪威特罗姆瑟的二级儿科门诊。参与者:80名(62.5%为男孩,37.5%为女孩)被诊断为鸡蛋过敏的儿童和青少年,他们必须遵循无蛋饮食,且不能食用任何含有任何量鸡蛋的食物,包括含蛋烘焙食品,否则会对鸡蛋蛋白产生过敏反应。我们还纳入了对鸡蛋敏感但从未接触过鸡蛋或含蛋烘焙食品且遵循无蛋饮食的患者。研究参与者的其他特应性疾病也进行了登记。干预措施:疫苗接种于2009年11月至12月进行。患者接种了一种卵清蛋白含量<0.33μg/ml的单价甲型流感(H1N1)疫苗。他们被分为两组,分别接受单剂量或分剂量疫苗接种。选择接受分剂量疫苗的患者是因为他们之前对鸡蛋有反应或从未接触过鸡蛋。主要结果:疫苗无严重不良反应;仅有1例轻度不良反应和2例可能的不良反应。结果:患者年龄从10个月至16.5岁不等。38名(48%)患者接受了分剂量疫苗接种。63名(79%)患者除鸡蛋过敏外还患有一种或多种特应性疾病。在特应性、血清特异性IgE水平或皮肤点刺试验方面,接受分剂量或单剂量疫苗接种的两组之间无显著差异。结论:该研究证实,对鸡蛋过敏的患者可以安全接种卵清蛋白含量<0.333μg/ml的常规流感疫苗,即使这些患者之前对鸡蛋有过敏反应且被诊断患有并发特应性疾病。