Allergy Asthma Immunol Res.  2020 Mar;12(2):359-363. 10.4168/aair.2020.12.2.359.

Delayed-Onset Anaphylaxis Caused by IgE Response to Influenza Vaccination

• Kim MJ
• Shim DH
• Cha HR
• Kim CB
• Kim SY
• Park JH
• Sohn MH
• Lee JM
• Kim KW

• KMID: 2468467
• DOI: http://doi.org/10.4168/aair.2020.12.2.359

Abstract

Influenza vaccine-associated anaphylaxis is a very rare allergic reaction to vaccines, but the most concerning and life-threatening adverse reaction. Although the safety of influenza vaccines has been well documented, occasional cases of anaphylaxis in vaccinated patients have been reported. In this study, we analyzed the immunoglobulin E (IgE) response to whole influenza vaccines in a pediatric case of delayed-onset anaphylaxis after influenza vaccination. The patient showed elevated specific IgE levels against whole influenza vaccines, especially with split virion from egg-based manufacturing process. Specific IgE levels to influenza vaccines showed decreased over. We evaluated a causal relationship between influenza vaccine and anaphylaxis event by enzyme-linked immunosorbent assay. Delayed-onset anaphylaxis after influenza vaccination can occur in children without predisposing allergic diseases. In addition, the results suggested that formulation and production system of influenza vaccines could affect the probability of severe allergic reaction to vaccines.

Keyword

Anaphylaxis; drug hypersensitivity; immunoglobulin E; influenza; vaccination; vaccines; delayed hypersensitivity

MeSH Terms

Anaphylaxis*
Child
Drug Hypersensitivity
Enzyme-Linked Immunosorbent Assay
Humans
Hypersensitivity
Hypersensitivity, Delayed
Immunoglobulin E*
Immunoglobulins
Influenza Vaccines
Influenza, Human*
Vaccination*
Vaccines
Virion
Immunoglobulin E
Immunoglobulins
Influenza Vaccines
Vaccines

Figure

• 

  Figure Measurements of specific IgE levels to influenza vaccines. (A) Comparison of the specific IgE levels against influenza vaccines between a patient and the controls. (B) Changes in the specific IgE levels to influenza vaccines in a patient on days 1, 3, 7 after anaphylaxis. IgE, immunoglobulin E; OD, optical density. *P < 0.01 vs. controls, †P < 0.001 vs. controls.

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