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Canadian Journal of Public Health

, Volume 102, Issue 3, pp 196–199 | Cite as

Administration of the Adjuvanted pH1N1 Vaccine in Egg-allergic Children at High Risk for Influenza A/H1N1 Disease

  • Jane E. SchulerCHEOEmail author
  • W. James King
  • Natalie L. Dayneka
  • Lynn Rastelli
  • Evelyn Marquis
  • Zave Chad
  • Charles Hui
Quantitative Research
  • 2 Downloads

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.

Design/Method

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.

Conclusion

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.

Key words

Influenza A/H1N1 vaccine child allergy 

Résumé

Contexte

Au Canada, le vaccin contre la grippe pH1N1 est recommandé pour les enfants, en particulier ceux qui ont moins de 5 ans ou une maladie chronique sous-jacente. Ce vaccin, qui contient une quantité résiduelle de protéines de blanc d’œuf (un allergène), peut poser un risque pour les enfants allergiques aux œufs.

Objectif

Décrire le résultat de l’administration du vaccin contre la grippe pH1N1 à des enfants allergiques aux œufs et à risque de contracter une forme grave de grippe H1N1.

Conception/Méthode

Étude prospective observationnelle de cohorte. Des enfants désignés comme étant à risque élevé de faire une allergie aux œufs et d’attraper la grippe H1N1 ont été vaccinés selon un protocole en deux doses divisées dans un environnement médical contrôlé. Les enfants ont reçu une première dose d’essai; ceux qui n’ont fait aucune réaction ont reçu le reste de la dose, et les enfants ont été suivis au cas où ils fassent des réactions allergiques. Ceux qui ont toléré la dose divisée et qui avaient besoin d’une seconde dose se sont fait offrir la vaccination quatre semaines plus tard en une seule injection.

Résultats

Soixante-deux enfants allergiques aux œufs considérés comme étant à risque élevé de contracter la grippe H1N1 ont reçu le vaccin anti-pH1N1 adjuvé. L’allergie aux œufs a été diagnostiquée cliniquement par un allergologiste ainsi que par des tests cutanés et/ou sériques de dépistage par recherche d’IgE. Dans un délai d’une heure après la vaccination, deux enfants ont fait de l’urticaire, un enfant a eu une réaction vasovagale, et un autre a eu un épisode hyporéactif. Quatorze enfants ont reçu la seconde dose du vaccin anti-H1N1, et l’un d’eux a présenté un érythème et des démangeaisons. Il n’y a eu aucune réaction anaphylactique.

Conclusion

L’administration du vaccin adjuvé anti-pH1N1 aux enfants allergiques aux œufs à risque de contracter une forme grave de grippe H1N1 était sans danger lorsque effectuée selon un protocole en deux doses divisées dans un environnement médical contrôlé.

Mots clés

virus A de la grippe sous-type H1N1 vaccins enfant allergènes 

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Copyright information

© The Canadian Public Health Association 2011

Authors and Affiliations

  • Jane E. SchulerCHEO
    • 1
    • 2
    Email author
  • W. James King
    • 1
    • 2
  • Natalie L. Dayneka
    • 3
  • Lynn Rastelli
    • 4
  • Evelyn Marquis
    • 4
  • Zave Chad
    • 1
  • Charles Hui
    • 1
    • 4
  1. 1.Department of Pediatrics, Faculty of MedicineUniversity of OttawaOttawaCanada
  2. 2.Division of Pediatric MedicineChildren’s Hospital of Eastern Ontario (CHEO)OttawaCanada
  3. 3.Department of PharmacyCHEOOttawaCanada
  4. 4.Division of Infectious DiseaseCHEOOttawaCanada

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