title: Administration of the adjuvanted pH1N1 vaccine in egg-allergic children at high risk for influenza A/H1N1 disease.
abstract: BACKGROUND
  In Canada, the pH1N1 influenza vaccine is recommended for children, particularly those less than 5 years of age or with chronic underlying disease. The pH1N1 vaccine, which contains residual allergenic egg white proteins, may pose a risk for vaccination of egg-allergic children.
  
  
  OBJECTIVE
  To describe the outcome of pH1N1 influenza vaccine administration to egg-allergic children at risk for severe H1N1 disease.
  
  
  METHODS
  Prospective observational cohort study. Children identified as at high risk for egg allergy and H1N1 influenza were vaccinated using a two-dose split protocol in a controlled medical setting. Children were given an initial test dose; if no reaction was noted, the remainder of the dose was administered and the children were followed for allergic reactions. Those who tolerated the split dose and required a second dose of vaccine were offered vaccination four weeks later as one injection.
  
  
  RESULTS
  Sixty-two egg-allergic children considered at high risk for H1N1 disease received the adjuvanted pH1N1 vaccine. Egg allergy was diagnosed both clinically by an allergist and using skin and/or serum IgE testing. Within one hour of immunization, 2 children developed hives, 1 had a vasovagal response and 1 had a hypo-responsive episode. Fourteen children received the second H1N1 dose and 1 developed erythema and itching. There were no anaphylactic reactions.
  
  
  CONCLUSIONS
  Administration of the adjuvanted pH1N1 vaccine in egg-allergic children at risk for severe H1N1 influenza was safe when performed in a two-dose split protocol in a controlled medical setting.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, ON. jschuler@cheo.on.ca
authors.forename: Jane E
authors.initials: JE
authors.lastname: Schuler
authors.forename: W James
authors.initials: WJ
authors.lastname: King
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Dayneka
authors.forename: Lynn
authors.initials: L
authors.lastname: Rastelli
authors.forename: Evelyn
authors.initials: E
authors.lastname: Marquis
authors.forename: Zave
authors.initials: Z
authors.lastname: Chad
authors.forename: Charles
authors.initials: C
authors.lastname: Hui
mesh_terms: D002170:Canada; D002648:Child; D002675:Child, Preschool; D021181:Egg Hypersensitivity; D005260:Female; D006801:Humans; D007115:Immunization Schedule; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D011446:Prospective Studies; D017751:Safety Management
chemical_list: D007252:Influenza Vaccines