Klimek L, Wicht-Langhammer S, von Bernus L, Thorn C, Cazan D, Pfaar O, Hörmann K
Zentrum für Rhinologie und Allergologie Wiesbaden, An den Quellen 10, 65183, Wiesbaden, Deutschland.
HNO-Universitätsklinik Mannheim, Mannheim, Deutschland.
HNO. 2017 Oct;65(10):834-839. doi: 10.1007/s00106-017-0363-7.
Allergic reactions to influenza vaccinations are a well-known phenomenon; however, only a few published statistics give information on the risks. Patients with a chicken egg allergy must be particularly carefully handled during an influenza epidemic where vaccines produced using embryonated chicken eggs are primarily employed.
A selective literature review and analysis of the problem of allergic reactions to vaccinations was performed.
The two most common relative contraindications among patients to be vaccinated are the presence of an egg allergy and a previous anaphylactic reaction to vaccination. These patients have a significantly increased risk of sustaining an adverse reaction. These high-risk patients should therefore only be vaccinated on the basis of thorough assessment of medical history, and then only with caution. The emergency routine must include sufficient precautionary measures, in case an anaphylactic reaction occurs.
Current guidelines for the treatment of anaphylactic reactions are to be observed. Immediate treatment of the first symptoms of an anaphylactic reaction-i.v. administration of adrenalin, antihistamines, cortisone, and in some cases betamimetics-can usually prevent anaphylactic shock. Alternatively, a graded vaccination ("split protocol") and overnight surveillance can be considered in this group of patients.
对流感疫苗的过敏反应是一种众所周知的现象；然而，仅有少数已发表的统计数据提供了有关风险的信息。在主要使用鸡胚生产的疫苗的流感流行期间，对鸡蛋过敏的患者必须格外谨慎处理。
对疫苗接种过敏反应问题进行了选择性文献综述和分析。
待接种疫苗的患者中两个最常见的相对禁忌证是存在鸡蛋过敏和既往有疫苗接种过敏反应。这些患者发生不良反应的风险显著增加。因此，这些高危患者应仅在全面评估病史的基础上接种疫苗，且接种时需谨慎。应急预案必须包括足够的预防措施，以防发生过敏反应。
应遵循当前过敏反应治疗指南。过敏反应最初症状的立即治疗——静脉注射肾上腺素、抗组胺药、皮质激素，在某些情况下使用β-拟交感神经药——通常可预防过敏性休克。或者，对于这类患者可考虑采用分级接种（“分步方案”）并进行过夜监测。
