CDC Immunization Experts OK Egg-Free Influenza Vaccine

Fran Lowry

June 21, 2013

Members of the Centers for Disease Control and Prevention's (CDC's) Advisory Committee on Immunization Practices (ACIP) have voted 13 to 0 in favor of recommending Flublok (Protein Sciences Corporation) to vaccinate people aged 18 through 49 years who have an egg allergy.

Flublok, a trivalent influenza vaccine, was approved on January 16 by the US Food and Drug Administration (FDA) and will be available for the 2013 to 2014 influenza season.

Unlike other approved influenza vaccines, Flublok does not use the influenza virus or chicken eggs in its manufacturing process. At this time, it is the only recombinant influenza vaccine approved for influenza.

The panel of experts also voted to add Fluzone (Sanofi Pasteur) to its list of available vaccines. Fluzone was licensed by the FDA earlier in June, said Lisa Grohskopf, MD, MPH, from the CDC's Influenza Division. It has a needle that is 90% smaller than average influenza hypodermics.

New Options for Egg Allergy

"The old guidance was that if a person's allergic reaction to eggs was only to have hives, they could get an inactivated influenza vaccine and then be observed for 30 minutes to make sure they had no reaction. Now, in addition to that option, they can get Flublok," Dr. Grohskopf told Medscape Medical News.

Flublok is also an option for individuals allergic to eggs who had more severe allergic reactions, such as dropping blood pressure, shortness of breath, wheezing, or gastrointestinal symptoms, as long as they are in the approved 18- to 49-year-old age group.

If not, the previous guidance — that they be evaluated by an allergy specialist before being vaccinated — still holds.

The APIC panel also voted to allow the addition of language to address the issue of people with no history of egg exposure but questionable allergy testing.

"We couldn't use the old guidance for this group because it was all based on what their symptoms are when they are exposed to egg. So we have added language to consider those situations where you have a person who does not have any known history of being exposed to eggs but who, for one reason or another, has had allergy testing and results that indicate a potential for egg allergy," Dr. Grohskopf said.

For these people, the recommendation is consultation with an allergy expert before vaccination, or if they are aged 18 to 49 years, Flublok would be an option.

"These were very subtle changes to the proposed influenza vaccination recommendations for 2013-2014. They weren't huge this time," Dr. Grohskopf added.

Dr. Grohskopf has disclosed no relevant financial relationships.

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