The safety of egg-containing vaccines for egg-allergic patients.
Forty-two patients with a history of egg sensitivity were evaluated for receiving avian-grown vaccines. After giving a history and undergoing physical examination, each patient was skin-tested with egg antigens and six egg-propagated vaccines, given an oral egg challenge, and finally, when possible, given a vaccine challenge. Thirty-seven of the 42 patients (88%) were ultimately given one or more of the vaccines with no reactions or only minimal ones to both egg protein and vaccine; they had mild reactions consisting of pruritus, headache, and apprehension. Immunization was withheld from three patients who had a history of severe reactions after egg ingestion and strongly positive skin reactivity to both egg and vaccine. A history of egg intolerance should not, by itself, disqualify a patient from receiving one of these vaccines. However, a history of exquisite sensitivity to egg protein indicates that a severe vaccine reaction is likely. An intradermal skin test utilizing 0.02 ml of a 1:100 dilution of the vaccine and resulting in a wheal of greater than 5 mm was found to be the test that most reliably predicted those patients who should not receive the vaccine.
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004531:Eggs; D005260:Female; D005512:Food Hypersensitivity / Q000276:immunology; D006801:Humans; D007114:Immunization; D008297:Male; D008875:Middle Aged; D010047:Ovalbumin / Q000008:administration & dosage / Q000009:adverse effects* / Q000276:immunology; D012882:Skin Tests; D014765:Viral Vaccines / Q000009:adverse effects*
D014765:Viral Vaccines; D010047:Ovalbumin