Safety of yellow fever vaccine administration in confirmed egg-allergic patients

Gerhardt, Clarissa Morais Busatto; Castro, Ana Paula Beltran Moschione; Pastorino, Antônio Carlos; Dorna, Mayra de Barros; Nunes-Santos, Cristiane J.; Aquilante, Bruna Pultrini; Miyaji, Karina Takesaki; Lopes, Marta Heloísa

doi:10.1016/j.vaccine.2020.08.020

Cited by 20 publications

(13 citation statements)

References 16 publications

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“…The egg concentration in the vaccine may vary between 2.43-4.42 µg/mL, values that are higher than the 2 µg/mL level, which is considered the maximum safe concentration for egg-allergic individuals [73,74]. However, case series of egg-allergic patients successfully vaccinated for yellow fever with a graded dosing challenge protocol have been published [75,76].…”

Section: Misconception #8: Egg Allergy Is a Contraindication For The Influenza Vaccinementioning

confidence: 99%

Addressing Common Misconceptions in Food Allergy: A Review

Anagnostou

2021

Children

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Background: Food allergies are common, affecting 1 in 13 school children in the United States and their prevalence is increasing. Many misconceptions exist with regards to food allergy prevention, diagnosis and management. Objective: The main objective of this review is to address misconceptions with regards to food allergies and discuss the optimal, evidence-based approach for patients who carry this diagnosis. Observations: Common misconceptions in terms of food allergy prevention include beliefs that breastfeeding and delayed introduction of allergenic foods prevent the development of food allergies. In terms of diagnosis, statements such as ‘larger skin prick tests or/and higher levels of food-specific IgE can predict the severity of food-induced allergic reactions’, or ‘Tryptase is always elevated in food-induced anaphylaxis’ are inaccurate. Additionally, egg allergy is not a contraindication for receiving the influenza vaccine, food-allergy related fatalities are rare and peanut oral immunotherapy, despite reported benefits, is not a cure for food allergies. Finally, not all infants with eczema will develop food allergies and epinephrine auto-injectors may unfortunately be both unavailable and underused in food-triggered anaphylaxis. Conclusions and relevance: Healthcare professionals must be familiar with recent evidence in the food allergy field and avoid common misunderstandings that may negatively affect prevention, diagnosis and management of this chronic disease.

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Section: Misconception #8: Egg Allergy Is a Contraindication For The Influenza Vaccinementioning

confidence: 99%

Addressing Common Misconceptions in Food Allergy: A Review

Anagnostou

2021

Children

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“…Another series of case reports by Gerhardt et al confirmed this finding. In addition, the authors found that performing an intradermal test is recommended to identify individuals with a higher risk of AEFIs ( Gerhardt et al, 2020 ) [c].…”

Section: Yellow Fever Vaccine [Sed-16 537–540; Seda-38 321; Seda-39 318–319; Seda-40 394–395; Seda-41 358]mentioning

confidence: 99%

Vaccines

Ambler

Towne

Brooks

2021

Side Effects of Drugs Annual

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“…However, the global incidence might be 10-250 times greater. 1 Since its introduction, the yellow fever vaccine (YFV) has proven to be the most effective way to prevent this disease, [1][2][3][4][5][6][7][8] granting 90% protection 10 days after its administration, and a single lifetime dose is sufficient. [1][2][3][4][5]8 YF vaccination is, therefore, important and required for residents and travelers of endemic regions.…”

Section: Introductionmentioning

confidence: 99%

“…1 Since its introduction, the yellow fever vaccine (YFV) has proven to be the most effective way to prevent this disease, [1][2][3][4][5][6][7][8] granting 90% protection 10 days after its administration, and a single lifetime dose is sufficient. [1][2][3][4][5]8 YF vaccination is, therefore, important and required for residents and travelers of endemic regions. 5,9,10 The WHO contraindicates the YFV application in patients with severe egg allergy, 1 and the manufacturers contraindicate its application in all egg-allergic patients (EAP), [11][12][13][14][15] as its cultivation in embryonated-chicken-eggs may represent a higher risk of adverse reactions in these populations because it contains residual ovalbumin and other egg proteins.…”

Section: Introductionmentioning

confidence: 99%

Frequency of allergic reactions in egg allergic patients after receiving the yellow fever vaccine

García-Paba

Aparicio

Rodríguez

et al. 2023

Allergol Immunopathol

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Background: Immunization with live attenuated viral yellow fever vaccine (YFV) grants effective immunity in most cases, and is recommended and prioritized for residents and travelers of endemic countries. YFV is seldom administered to egg-allergic patients (EAP) since it is cultivated in embryonated chicken eggs and may contain residual egg proteins, being a problem for egg-allergic residents and travelers of endemic countries. Objective: Describe the frequency of allergic reactions after YFV administration in confirmed EAP from an allergy outpatient center in Bogotá, Colombia. Methods: An observational, retrospective, cross-sectional, and descriptive study was conducted from January 2017 to December 2019. EAP whose allergy was confirmed with a positive Skin Prick Test (SPT) and/or egg protein–specific IgE levels who hadn’t received the YFV were included. Every patient had an SPT, severe EAP, and an additional Intradermal Test (IDT) done with the vaccine. If the vaccine SPT and IDT were negative, the YFV was administered as a single dose; if either were positive, the YFV was administered in graded doses. Statistical analysis was done in Stata16MP. Results: Seventy one patients were included, 24 (33.8%) of those had a history of egg anaphylaxis. All patients had negative YFV SPTs, and two of the five YVF IDTs were positive. Two patients, with previous egg-anaphylaxis, presented allergic reactions to the vaccine. Conclusions: YFV did not trigger allergic reactions in EAP without history of egg-anaphylaxis. With further research, safe single-dose vaccination to this population could be considered; however, patients with previous egg-anaphylaxis should be evaluated by an allergist before vaccination.

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Safety of yellow fever vaccine administration in confirmed egg-allergic patients

Cited by 20 publications

References 16 publications

Addressing Common Misconceptions in Food Allergy: A Review

Addressing Common Misconceptions in Food Allergy: A Review

Vaccines

Frequency of allergic reactions in egg allergic patients after receiving the yellow fever vaccine

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