James et al were able to successfully vaccinate patients with egg allergy against influenza using a standard protocol. The authors are from 11 medical centers across the Unites States.
Patients were selected for the protocol if they had a convincing history of egg allergy or a positive oral challenge test.
The authors found skin tests to be unreliable for predicting serious allergic reactions..
The influenza vaccine used has to have a low egg protein concentration (<= 1.2 µg/mL). The study used the vaccine from Parke Davis.
(1) Vaccines are administered in a clinical setting with emergency treatment supplies immediately available.
(2) Two doses were administered 30 minutes apart as an intramuscular (IM) injection. The first dose was 10% of the standard recommended dose.
(3) If any immediate adverse reaction (bronchospasm, laryngeal edema, generalized urticaria, anaphylaxis) were observed during the 30 minutes after the first dose, then the second dose administration was aborted.
(4) The second dose was the remaining 90% of the standard recommended dose.
(5) The patient was observed at least an hour after the second dose before being released.
(6) Followup was made with the patient or guardian at 24 and 48 hours to detect any delayed adverse reaction.
(7) A booster dose was given to patients receiving primary vaccination 1 month after the first dose. This was administered as a single injection.
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Specialty: Infectious Diseases, Pharmacology, clinical