Flu vaccination advice for 2011/2012 season

[AdminCM]

Flu vaccination advice for 2011/2012 season

CMdeux posted on 08/18/11 at 05:19 pm:

http://www.medpagetoday.com/InfectiousDisease/URItheFlu/28107

Most importantly to those of us here at FAS:

Although the guidance is largely similar to that from previous seasons, additional updates include the availability of the intradermal formulation of Fluzone -- which was approved by the FDA in May -- and new recommendations regarding vaccination in individuals with egg allergy -- which were discussed at one of ACIP's meetings in June.

Included in the recommendations for vaccination in the presence of egg allergy:

•Those with a history of hives only after exposure to egg can receive influenza vaccine, but should receive the trivalent inactivated vaccine (TIV) rather than the live attenuated influenza vaccine (LAIV), should be vaccinated by a healthcare provider who is familiar with potential manifestations of egg allergy, and should be observed for at least 30 minutes following administration.
•People who have had more severe allergic reactions to egg should be referred to a physician with expertise in the management of allergies for further risk assessment.
•The vaccine should be administered in settings equipped for the rapid recognition and treatment of anaphylaxis.

The authors noted that a previous severe allergic reaction to influenza vaccine, regardless of the component causing the reaction, is a contraindication to getting the vaccine.

This is a bit of a pull-back from last year's "It's fine for EVERYONE, even those with egg allergy" advice.      Hopefully many allergists will continue offering testing and split dosing with low-egg-protein lots. 

[lilpig99]

DS is anahylactic to egg and just got a successful flu vaccination last week. It was administered at our allergists office, as his regular pediatrician will not do it. Instead of the 1/10th - 9/10th split dosing schedule that he's had before, they opted for 1/5th- 4/5ths this time. Only a small bump at the injection site, a little redness, nothing else. He was fine throughout the night, but I did give him tylenol as I usually do with any vaccination.

You can read about our 'should we or should we not' journey irt the flu vaccine, here: AAAAI says Flu vax ok for egg-allergic!! (Fall 2010)

So glad this flu vaccine is still working out for my son Hope any other egg allergic kiddos have success too!

[GingerPye]

Both of my egg-allergic kids had the flu shot this fall for the first time.  I'm still amazed that they had it successfully; we did the 10%/90% split but neither child had ANY kind of anything.  No redness, no swelling, no nothing.  I'm very amazed.  And so glad that they could have it this year.

[lilpig99]

Hi GP!

Mayo Clinic continues to study egg-allergic children and the flu vaccine. For more info: http://clinicaltrials.mayo.edu/clinicaltrialdetails.cfm?trial_id=101668

HTH.

[maeve]

DD had the flu vaccine for the first time this year.  She had it at her pediatrician's office after they received a note from the allergist.  She just got one shot.  We remained in the office for 30 minutes afterward.  Everything was fine.  Her arm was sore at the site of the injection but there were no other issues.

[Macabre]

Are there any updates for 2012?

[CMdeux]

Seems to be the same as last year, though I haven't looked specifically-- basically, anyone with egg allergy Hx which is severe should contact their allergist to discuss it.

Split dosing seems to be losing fashion over time, since for most people who tolerate an intradermal skin test well, they have no real difficulty tolerating the full dose, either.  It seems like allergists like to do a skin test though, before dosing someone with anaphylaxis Hx.

We did have to treat the flu jab about like an allergy injection, though-- caution about activity afterwards, stay in the office 40 minutes, etc.

[Ciel]

Last year I had no reaction at all to the flu shot, but this year I had a large red welt about the size of my open palm around the injection site. It took over a week to go away. In 2008 I had the same localized swelling and welts -- Anxiety over the possibility of escalation with further exposures prevented me from getting a flu shot in 2009 & 2010, until my respirologist gave me a stern lecture last year and I decided to heed his advice. I do not have a history of anaphylaxis with egg & have only ever reacted mildly to ingestion of actual egg protein. There are just so many factors and variables with this kind of stuff. My brain feels soggy with trying to understand sometimes.