Article in Japanese
A case series study on adverse events after influenza vaccination
Sho MORI1), Mizuho NAGAO1), Shigeru SUGA1), Takao FUJISAWA1)
Adverse events (AEs) in influenza vaccination include severe local reactions and anaphylaxis. To investigate underlying immunological mechanisms of AEs and identify risk factors of anaphylaxis, a case series study was performed. Twelve anaphylaxisis patients (A group) and 33 with strong local reactions (L group) were investigated. Their median age was 4.5 and 3.5 years and male/female ratio 10/2 and 22/11 in the A and L groups, respectively. Co-morbid diseases were allergies and atopic dermatitis in 36% and 11%, food allergy in 36% and 32% and asthma in 9% and 29% of the A and L groups, respectively. Allergen sensitization was tested by a multiplex specific IgE assay system and 90% and 80% of the A and L groups, respectively, were positive for at least 1 allergen out of the 39 tested. The mean number of sensitized allergens was 11 and 10 in the A and L groups, respectively. The skin prick test using the vaccine and vaccine-induced basophil activation were positive in 100% and 25% and 100% and 97% of subjects in the A and L groups, respectively. Antihistamines were administered before subsequent vaccination in 13 patients in the L group, resulting in milder local reactions rather than initial reactions in 12 of them. These results suggest that the AEs were induced by IgE antibody to influenza vaccine, and that predisposition to the male gender and allergic diathesis in AEs may exist, but factors that predict anaphylaxis are unknown.
1) Department of Pediatrics, Mie National Hospital, National Hospital Organization
|Key words||influenza vaccination, anaphylaxis, local reactions, specific IgE antibody, basophil activation test|
|Received||December 27, 2019|
|Accepted||May 15, 2020|