Safety of Influenza Vaccination in Allergic Children

Bierman, Charles W.; Shapiro, Gail G.; Pierson, William E.; Taylor, J W; Foy, Hjordis M.; Fox, John P.

doi:10.1093/infdis/136.supplement_3.s652

Cited by 76 publications

(34 citation statements)

References 3 publications

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“…In that context, this study was carried out. There are reports that temporary treatment with high-dose steroids for asthmatic patients does not influence immunogenicity (21,22), as reported for long-term steroid therapy (23,24). Moreover, another study demonstrated that steroids did not influence the immunogenicity of influenza virus vaccination, and aggravation of asthmatic symptoms was not noted after vaccination among asthmatic children (8,25,26).…”

Section: Discussionmentioning

confidence: 93%

Immunogenicity and Safety of an Inactivated Trivalent Split Influenza Virus Vaccine in Young Children with Recurrent Wheezing

Bae

Choi

Kwon

et al. 2013

Clin Vaccine Immunol

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e Influenza virus vaccination is recommended for children, but so far, active vaccination has not been achieved because most parents lack knowledge of vaccine safety and many doctors are reluctant to administer vaccine due to concerns that steroids might alter immunogenicity. The aim of this study was to compare the immunogenicity and safety of inactivated trivalent split influenza virus vaccine between children with recurrent wheezing and healthy children of the same age group. Sixty-eight healthy children and 62 children with recurrent wheezing took part in this study. Seroconversion rates, seroprotection rates, geometric mean titers (GMTs), and geometric mean titer ratios (GMTRs) were measured by a hemagglutination inhibition assay for the assessment of immunogenicity. Solicited and unsolicited local and systemic adverse events were measured for the assessment of safety. Regarding immunogenicity, the seroconversion and seroprotection rates showed no difference overall between healthy children and children with recurrent wheezing. Also, no difference was observed between steroid-treated and nontreated groups with recurrent wheezing. Generally, the GMTs after vaccination were higher in the one-dose vaccination groups for healthy children and children with recurrent wheezing, but the GMTRs revealed different results according to strain in the two groups. Regarding safety, solicited local and systemic adverse events showed no differences between healthy children and children with recurrent wheezing. This study demonstrates that inactivated split influenza virus vaccine is able to induce protective immune responses in healthy children, as observed in previous studies, as well as in children with recurrent wheezing who require frequent steroid treatment.

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Section: Discussionmentioning

confidence: 93%

Immunogenicity and Safety of an Inactivated Trivalent Split Influenza Virus Vaccine in Young Children with Recurrent Wheezing

Bae

Choi

Kwon

et al. 2013

Clin Vaccine Immunol

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“…Anaphylaxis is a recognized risk of influenza and other vaccines [43,44]. Another six reports described deaths within approximately 1 h after vaccination; we could not assess from available data whether these vaccinees had unrecognized anaphylactic reactions or some other event, such as arrhythmia, either not detected or not included in the report.…”

Section: Discussionmentioning

confidence: 98%

Safety of trivalent inactivated influenza vaccines in adults: Background for pandemic influenza vaccine safety monitoring

Vellozzi

Burwen

Dobardzic

et al. 2009

Vaccine

171

122

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a b s t r a c tIn preparation for pandemic vaccine safety monitoring, we assessed adverse events reported to the Vaccine Adverse Event Reporting System following receipt of trivalent inactivated influenza vaccines among adults from 1990 through 2005. We calculated reporting rates for nonserious, serious, and neurological adverse events. We reviewed reports of recurrent events and deaths, as well as reports identified through advanced signal detection. The most frequently reported events were local reactions and systemic symptoms. Guillain-Barré syndrome was the most frequently reported serious event (0.70 reports per million vaccinations). Adverse event reporting rates have been reasonably constant over time. No new safety concerns emerged after our review of 15 years of post-licensure surveillance data. These findings provide useful information if pandemic vaccine is rapidly distributed and pre-licensure data are limited.Published by Elsevier Ltd. BackgroundInfluenza vaccines are the primary method for the control of influenza and its complications and the most widely used type of vaccine for adults in the United States (US). The US and much of the world is preparing for the use of pandemic influenza vaccines [1]. However, even with extensive planning, limited safety data will be available for these vaccines prior to use. Safety profile highlights of the seasonal trivalent inactivated influenza vaccines (TIV) can provide a background for interpretation of adverse events that can be anticipated if pandemic influenza vaccines must be employed in the future. In addition, special importance for TIV safety monitoring stems from the 1976-1977 influenza season, when a mass vaccination effort in the US against swine influenza was halted after the vaccines appeared to be associated with an elevated risk of Guillain-Barré syndrome (GBS) [2].Placebo-controlled trials among older and healthy young adults have demonstrated that TIV administration is not associated with an increased risk of systemic symptoms (e.g., fever, malaise, myalgia); the most frequent adverse effect following vaccination is pain at the injection site [3] including anaphylaxis can occur [3], but the latter is rare [4]. A pre-licensure study of the recently licensed H5N1 vaccine identified headache, malaise, and myalgia as the most frequent systemic symptoms but also identified these at similar rates among placebo recipients [5]. Clinical trials are generally not large enough to detect rare adverse events. Post-licensure safety data provide examples of adverse event experiences among a larger and more diverse population, and reporting of adverse events following receipt of seasonal TIV to the US Vaccine Adverse Event Reporting System (VAERS) is an important source of this information. We examined 15 years of VAERS data among adults aged ≥18 years to describe patterns of adverse events after seasonal vaccines and to identify possible safety concerns that might merit intensified monitoring or evaluation. Although pandemic influenza vaccines will differ fr...

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“…Studies conducted more than 25 years ago demonstrated lower influenza vaccine tolerance rates between 71% and 87% by eggallergic patients. [18][19][20] These studies, however, were not designed specifically to examine the safety of skintest removal from the influenza vaccine protocol for egg-allergic children.…”

Section: Discussionmentioning

confidence: 99%

“…As early as the 1970s, study results indicated that patients with egg allergy should undergo skin testing with the influenza vaccine. [18][19][20] If the skin-test result were negative, the influenza vaccine could be safely administered. If the skin-test result were positive, the recommendation was not to administer the vaccine.…”

mentioning

confidence: 99%

Safety of Influenza Vaccine Administration in Egg-Allergic Patients

Chung¹,

Huang²,

Schneider

2010

Pediatrics

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OBJECTIVE: Current guidelines recommend that egg-allergic patients receive an influenza vaccine skin test before the influenza vaccine. This study evaluated the safety of bypassing the skin test and administering graded doses of influenza vaccine to egg-allergic children. METHODS: We conducted a retrospective chart-review study of egg-allergic patients aged 6 months to 18 years who received the vaccine skin test and/or a 2-dose graded influenza vaccine. Between influenza seasons 2002–2003 and 2006–2007, egg-allergic patients underwent a vaccine skin test before influenza vaccine administration. Starting in 2006–2007, the skin test was removed from our protocol and egg-allergic patients received the influenza vaccine in 2 graded doses. All vaccinated patients were observed for adverse reactions. RESULTS: Two hundred sixty-one egg-allergic patients were evaluated for influenza vaccine administration, and 171 went on to receive the vaccine. Of the 56 patients who received the skin test before the influenza vaccine, 95% (exact 95% confidence interval [CI]: 85.1–98.9) tolerated the vaccine without a serious adverse reaction. This rate was unchanged after the vaccine skin test was removed from the protocol. Of the 115 patients who received the vaccine without a preceding skin test, 97% (exact 95% CI: 91.3–99.0) tolerated the vaccine without serious adverse reaction. The tolerance rate ratio was 1.01 (95% CI: 0.97–1.06). CONCLUSION: The results of our study suggest that egg-allergic patients without anaphylaxis to egg may safely receive the influenza vaccine in a 2-dose, graded fashion without a vaccine skin test.

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Safety of Influenza Vaccination in Allergic Children

Cited by 76 publications

References 3 publications

Immunogenicity and Safety of an Inactivated Trivalent Split Influenza Virus Vaccine in Young Children with Recurrent Wheezing

Immunogenicity and Safety of an Inactivated Trivalent Split Influenza Virus Vaccine in Young Children with Recurrent Wheezing

Safety of trivalent inactivated influenza vaccines in adults: Background for pandemic influenza vaccine safety monitoring

Safety of Influenza Vaccine Administration in Egg-Allergic Patients

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