Tanos Lopes FT, Maia de Castro Romanelli R, Isabela de Oliveira L, Abrantes MM, Rocha W. Safe administration of yellow fever vaccine in patients with suspected egg allergy.
J Allergy Clin Immunol Glob 2023;
2:100089. [PMID:
37779530 PMCID:
PMC10509842 DOI:
10.1016/j.jacig.2023.100089]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/14/2022] [Accepted: 11/28/2022] [Indexed: 10/03/2023]
Abstract
Background
The evidence available in the literature on the administration and safety of the yellow fever vaccine in patients with egg allergy is limited.
Objective
We sought to describe the administration of yellow fever vaccine in children with suspected egg allergy using a simplified protocol.
Methods
Children referred to the service from February 2018 to January 2020 with a history of possible egg allergy were classified as probably egg-allergic or not on the basis of history and specific IgE testing. A vaccine prick test was performed only in those with a history of an anaphylactic reaction to egg ingestion and if the result was positive the vaccine was administered in a 2-step protocol (2 equal doses of 0.25 mL with an interval of 30 minutes between the 2 applications). All other children received the vaccine as a single dose.
Results
A total of 435 children were evaluated; 48.27% were probably not allergic, and 51.72% were probably allergic to egg, of which 32.88% were considered anaphylactic. A total of 414 (95.2%) children had no vaccine reactions. Of the 21 (4.8%) children who had some reaction, 10 experienced a local reaction, 9 a mild skin reaction distant from the vaccine site, 1 presented local cutaneous reaction distant to the vaccination site, and 1 patient developed possible anaphylaxis. The vaccine prick test did not predict a vaccine reaction (odds ratio, 1.29; 95% CI, 0.25-6.72; P = .67).
Conclusions
Yellow fever vaccine can be safely administered as a single dose in children with a confirmed or suspected egg allergy.
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