James J M, Burks A W, Roberson P K, Sampson H A
Department of Pediatrics, Arkansas Children's Hospital Research Institute, Little Rock, USA.
N Engl J Med. 1995 May 11;332(19):1262-6. doi: 10.1056/NEJM199505113321904.
The safety of administering the combined measles-mumps-rubella (MMR) vaccine to patients who are allergic to eggs has been debated for decades because of concern about potential anaphylaxis, since the live attenuated virus used in the vaccine is grown in cultured chick-embryo fibroblasts.
We recruited 54 children (mean age, 18.5 months) who had not previously been vaccinated and were allergic to eggs. The children's histories of allergy were confirmed with skin tests and double-blind, placebo-controlled food-challenge tests; some children also underwent skin testing with the MMR vaccine. We then routinely administered the vaccine to the children in one subcutaneous (0.5-ml) dose.
All 54 children had positive results on skin testing with egg. Allergy to eggs was confirmed in 26 of the children by convincing histories of anaphylaxis after the ingestion of eggs, in 22 children by food-challenge tests, and in 6 patients by convincing histories of recent allergic reactions occurring after the ingestion of eggs. Of the 17 children who underwent skin testing with the MMR vaccine, 3 had positive results. All 54 children received the MMR vaccine as a single subcutaneous injection; none had an immediate or delayed adverse reaction.
The MMR vaccine can be safely administered in a single dose to children with allergy to eggs, even those with severe hypersensitivity.
由于担心潜在的过敏反应，数十年来，对于对鸡蛋过敏的患者接种麻疹-腮腺炎-风疹（MMR）联合疫苗的安全性一直存在争议，因为该疫苗中使用的减毒活病毒是在鸡胚成纤维细胞培养物中培养的。
我们招募了54名之前未接种过疫苗且对鸡蛋过敏的儿童（平均年龄18.5个月）。通过皮肤试验以及双盲、安慰剂对照的食物激发试验来确认儿童的过敏史；部分儿童还接受了MMR疫苗的皮肤试验。然后我们按照常规给这些儿童皮下注射一剂（0.5毫升）疫苗。
所有54名儿童的鸡蛋皮肤试验结果均为阳性。26名儿童通过摄入鸡蛋后出现令人信服的过敏反应病史确诊对鸡蛋过敏，22名儿童通过食物激发试验确诊，6名患者通过摄入鸡蛋后近期出现令人信服的过敏反应病史确诊。在接受MMR疫苗皮肤试验的17名儿童中，3名结果呈阳性。所有54名儿童均接受了单次皮下注射MMR疫苗；无人出现即刻或延迟不良反应。
MMR疫苗可以单剂量安全地接种给对鸡蛋过敏的儿童，即使是那些有严重过敏反应的儿童。
