Seasonal split influenza vaccine induced IgE sensitization against influenza vaccine |
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| Affiliation: | 1. Kitasato Institute for Life Sciences, Laboratory of Viral Infection, Tokyo, Japan;2. Kumagai Pediatric Clinic, Sapporo, Japan;3. Konan Kosei Hospital, Department of Pediatrics, Konan, Aichi Prefecture, Japan;4. Okafuji Pediatric Clinic, Himeji, Hyogo Prefecture, Japan;5. Suzuki Pediatric Clinic, Ube, Yamaguchi Prefecture, Japan;6. Saiwai Pediatric Clinic, Tachikawa, Tokyo, Japan;7. Fukuoka Dental College, Division of Oral & Medical Management, Department of Medicine, Section of Pediatrics, Fukuoka, Fukuoka Prefecture, Japan;8. National Mie Hospital, Department of Pediatrics, Tsu, Mie Prefecture, Japan;1. Department of Allergy, Guy''s and St Thomas'' NHS Foundation Trust, London, United Kingdom;2. Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, University of Hong Kong, Hong Kong, China;3. Department of Allergy, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom;4. Division of Asthma, Allergy and Lung Biology, Kings College London, School of Medicine, Guys Hospital, London, United Kingdom;6. Medical Research Council and Asthma UK Centre for Allergic Mechanisms of Asthma, London, United Kingdom;1. Department of Dermatology and Allergy, Danish Anaesthesia Allergy Centre, Allergy Clinic, Herlev and Gentofte Hospital, University of Copenhagen, Denmark;2. Department of Orthopedic Surgery, Amager and Hvidovre Hospital, University of Copenhagen, Denmark;1. Department of Pathobiology, University of Guelph, Guelph, Ontario N1G 2W1, Canada;2. Guelph Research and Development Centre, Agriculture and Agri-Food Canada, Guelph, Ontario N1G 5C9, Canada;3. Beijing Agro-Biotechnology Research Center, Beijing Academy of Agriculture and Forestry Sciences, Beijing, 100097 China;1. Department of Infectious Diseases, St. Jude Children''s Research Hospital, Memphis, TN 38105-3678, USA;2. Animal Resource Center, St. Jude Children''s Research Hospital, Memphis, TN 38105-3678, USA;3. Viral Infectious Disease Research Center, Korea Research Institute of Bioscience and Biotechnology, 125 Gwahak-ro, Youseong-gu, Daejeon 305-806, South Korea |
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| Abstract: | Although anaphylaxis is an extremely rare vaccine-associated adverse event, it occurred in young children following administration of the 2011/12 seasonal split influenza vaccine, which contained 2-phenoxyethanol as the preservative. These children had high levels of IgE antibodies against influenza vaccine components. We herein investigated why these children were sensitized. One hundred and seventeen series of serum samples were obtained immediately before, and one month after the first and second immunizations with the HA split vaccine of 2011/12. Forty-two sequential serum samples were collected in the acute and convalescent phases (2 and 4 weeks) after natural infection with H1N1 Pdm in 2009. IgE antibodies developed following the vaccination of young children with seasonal split vaccines, whereas no significant IgE response was observed following natural infection with H1N1 Pdm 2009. The prevalence of IgE antibodies was not influenced by outbreaks of H1N1 Pdm. Repeated immunization with the HA split vaccine induced IgE sensitization against the influenza vaccine irrespective of the H1N1, H3N2, or B influenza subtypes. The reasons why anaphylaxis only occurred in recipients of the influenza vaccine containing 2-phenoxyethanol are still being investigated, and the size distribution of antigen particles may have shifted to a slightly larger size. Since the fundamental reason was IgE sensitization, current split formulation for the seasonal influenza vaccine needs to be reconsidered to prevent the induction of IgE sensitization. |
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| Keywords: | Influenza vaccine Split vaccine Anaphylaxis IgE antibody IgG4 antibody |
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