Title: “Real World” Influenza Vaccination Practice Patterns in Egg-Allergic Patients
Abstract: RATIONALE: All available seasonal and H1N1 influenza vaccines contain egg protein. Therefore, vaccine administration poses a risk of allergic reaction in patients with egg allergy. For 2009, the AAAAI recommended influenza vaccine skin testing followed by test dosing, for egg-allergic patients prior to vaccine administration. We sought to determine “real world” patterns of influenza vaccine administration in egg-allergic patients. METHODS: This was a retrospective review of medical records of patients with physician-diagnosed egg-allergy, ages 1 to 65 years, followed by the North Shore-Long Island Jewish Health System Division of Allergy between 2006 and 2010. RESULTS: A total of 119 egg allergic patients were identified. Of these, 51 (43%) did not receive an influenza vaccine. Forty-two patients (35%) received an influenza vaccine in our office according to 2009 AAAAI recommendations and no adverse reactions occurred. However, 26 patients (22%) had received an influenza vaccine at other physicians' offices without vaccine testing or test dosing. Of the data available from these patients, 5/20 (25%) reported adverse reactions, 11/20 (55%) were given an influenza vaccine information statement, and 10/20 (50%) knew that severe egg allergy was a contraindication for influenza vaccine administration. CONCLUSIONS: Adverse reactions may occur in egg-allergic patients receiving influenza vaccine. Therefore, vaccine skin testing and/or test dosing should be considered for egg-allergic individuals. Each fall and winter, primary care providers should familiarize themselves with vaccine administration guidelines and contraindications, as recommendations may change from year to year. Also, improved educational measures are needed for egg-allergic patients regarding immunization with egg-protein containing vaccines.