AAAAI: Live Attenuated Flu Vaccine Appears Safe for Children with Egg Allergies and Asthma

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Research suggests health department guidelines may be overly restrictive

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Researchers in London have found that the live attenuated influenza vaccine (LAIV) may be perfectly safe for children who suffer from egg allergies or children with well-controlled asthma.

LAIV is an intranasal vaccine administered via the nose and licensed for use in children. As part of the SNIFFLE study, researchers administered 433 doses of LAIV to 282 children with egg allergy, two thirds of whom had a physician-diagnosis of asthma/recurrent wheezing. Almost half of these children had severe egg allergies, having previously experienced anaphylactic reactions to egg.

No systemic allergic reactions occurred with the egg-allergic children. Similarly, no increase in significant respiratory symptoms were seen in the children with asthma or a history of recurrent wheezing. Not a single child who participated in the study required medical intervention beyond routine treatments. “The data imply that LAIV is safe for use in children with egg allergy and well-controlled asthma,” first author Paul J. Turner, FRACP, PhD, with the Imperial College London, said.

“The SNIFFLE project has demonstrated that it is very likely that the LAIV vaccine would not cause allergic reactions due to the egg content in the vaccine, even in children with previous anaphylaxis to egg. Furthermore, we did not see children with well-controlled asthma experience lower airway symptoms following vaccination more than that reported for non-asthmatic, low risk children,” he explained.

Guidelines from the US, Canada, and UK recommend annual influenza vaccination of children, including those with egg allergy. However, this vaccine contains egg protein and current guidance suggests it should not be used in children with egg allergy. Furthermore, North American guidelines recommend against its use in children with asthma.

The current guidelines are based on legitimate concerns, but an absence of evidence. “We need data to address these issues and provide the evidence that the vaccine is safe in these children. To a large extent, the SNIFFLE study is the first large-trial to provide the safety data needed.”

“Children with reactive airways disease are at higher risk of severe influenza infection. Egg allergic children often have reactive airways disease - 67% in the SNIFFLE study - so our data goes a long way to providing the reassurance needed to parents and healthcare professionals that LAIV is safe in these children,” Turner explained.

On a lighter note, Turner also points out that LAIV is needle-free, which is certainly something children, parents and pediatricians can be happy for.

The study was published on February 13, 2015 in The Journal of Allergy and Clinical Immunology (JACI), an official journal of the American Academy of Allergy, Asthma & Immunology (AAAAI). SNIFFLE study investigators are comprised of researchers from the UK and Australia.

More information on egg allergies and asthma is available at the AAAAI website. The full study can be accessed through the JACI.

The AAAAI represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 6,800 members in the United States, Canada and 72 other countries. The AAAAI’s Find an Allergist/Immunologist service is a trusted resource to help you find a specialist close to home.

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