Safe vaccination of patients with egg allergy by using live attenuated influenza vaccine

Influenza Vaccine and Egg Allergy: Nearing the End of an Evidence-Based Journey

“…A telephone follow-up 24 hours later revealed a somewhat higher rate of nonspecific adverse reactions in the subjects with egg allergy than in the controls, but none were suggestive of allergic reactions. 9 Although this is the only published study on the use of LAIV in recipients with egg allergy and included only 68 subjects, the results are consistent with the multitude of published studies that describe literally thousands of patients with egg allergy who have uneventfully received IIV that contained as much or more egg protein. 2 Thus, it appears that the use of LAIV in children with egg allergy is safe.…”

“…They also included 55 control children without a history of egg allergy. 9 All of the patients were administered LAIV in the usual manner and kept under observation for 1 hour, during which no allergic reactions were observed. A telephone follow-up 24 hours later revealed a somewhat higher rate of nonspecific adverse reactions in the subjects with egg allergy than in the controls, but none were suggestive of allergic reactions.…”

Prevention and Control of Seasonal Influenza with Vaccines

“…Subsequently, several evaluations of LAIV use in persons with egg allergy have been published. In a prospective cohort study of children aged 2 through 16 years (68 with egg allergy and 55 without), all of whom received LAIV, none of the egg-allergic subjects developed signs or symptoms of an allergic reaction during the one hour of postvaccination observation, and none reported adverse reactions that were suggestive of allergic reaction or that required medical attention after 24 hours (437). In a larger study of 282 egg-allergic children aged 2 through 17 years (115 of whom had experienced anaphylactic reactions to egg previously), no systemic allergic reactions were observed after LAIV administration (438).…”

Summary of the NACI Statement on Seasonal Influenza Vaccine for 2017–2018

“…For the review of LAIV use in egg-allergic individuals, data were obtained from three prospective cohort studies in the United Kingdom (UK) and Canada (8)(9)(10). Post-licensure safety data from the Canadian Adverse Events Following Immunization Surveillance System (CAEFISS) was analyzed to seek reports of adverse events in influenza vaccine recipients who describe a history of allergy to eggs.…”

“…However, the safety of LAIV in egg-allergic individuals has now been studied in more than 1,100 children and adolescents (2-18 years of age) in the UK and Canada (8)(9)(10). After careful review of recently published studies, NACI concludes that egg-allergic individuals may be vaccinated against influenza using the low ovalbumin-containing LAIV licensed for use in Canada.…”