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Yellow fever vaccine should not be postponed for egg-allergic patients, as allergy risk is low. Furthermore, pre-vaccine testing lacks diagnostic value and causes unnecessary delays.
A new cohort study suggests that the yellow fever vaccine (YFV) is safe for individuals with egg allergies, even those with a history of severe egg reactions. Despite concerns about potential hypersensitivity, researchers found no allergic reactions following YFV administration, calling into question the necessity of pre-vaccination allergy testing and vaccine delays.
Egg Allergy and Vaccine Hesitancy: A Risky Delay
Egg allergy (IgE-mediated), often diagnosed in infancy, has historically raised concerns about vaccine safety, particularly for vaccines cultured in egg-based mediums like YFV. These concerns have led to precautionary allergy testing and postponed vaccinations, leaving patients at risk for preventable diseases.
Hence, this study issued in "International Archives of Allergy and Immunology" spanning nearly a decade (2014–2023) analyzed 171 patients with documented egg allergies, investigating their reactions after YFV administration. Researchers reviewed patient histories, prior allergic responses, and results from skin prick tests and intradermal tests for both egg and YFV.
Study Findings: No Allergic Reactions, Despite Positive Tests
Among the enrolled subjects, 23.9% had experienced egg-induced anaphylaxis. Despite 26 subjects testing positive for hypersensitivity (5 via skin prick tests and 21 via intradermal tests), all volunteers tolerated YFV without any allergic reactions. Notably, the absence of adverse reactions was consistent across patients regardless of:
The study also uncovered a troubling trend—nearly half (46.1%) of egg-allergic patients experienced delayed YFV administration, with 14% waiting over a year. Researchers highlighted that these delays stemmed from unnecessary hypersensitivity testing, which failed to anticipate actual vaccine tolerance.
Allergy Testing Before YFV
This study challenges the long-standing practice of withholding YFV in egg-allergic individuals and questions the reliability of pre-vaccine allergy testing. Researchers conclude that YFV should not be deferred, even in those with a history of severe egg-related allergic reactions, as the risk of an allergic response is negligible.
With these findings, experts urge healthcare personnel to reconsider vaccine protocols and prioritize timely immunization over precautionary but unwarranted delays.
International Archives of Allergy and Immunology
No Yellow Fever Vaccine Reactions in IgE-Mediated Egg Allergic Patients
Ruth-Helena Ramírez-Giraldo et al.
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