Выбор вакцины: яичный вопрос

[birdname]

Моему обормоту через неделю год, и, соответственно, назревает прививка от кори-краснухи-паротита. У мальчика пищевая аллергия на белок куриного яйца (сыпь). Помогите, пожалуйста, выбрать вакцину: с одной стороны, вроде бы, импортные вакцины имеют лучшую степень очистки, а с другой - отечественные на перепелиных яйцах.
Заранее спасибо.

[AlexGold]

Я позволю себе скопировать сюда ответ доктора Рассела Стила (извините, что на английском), который был совсем недавно опубликован на Medscape Pediatrics в ответ на аналогичный вопрос:

Ask the Experts about Vaccines - [Ссылки доступны только зарегистрированным пользователям ]
From Medscape Pediatrics

Immunizations for Child With Egg Allergy

Question

I am managing a 14-month-old boy with chronic atopic eczema who has a history of egg allergy, characterized by angioneurotic edema and urticaria after ingesting egg. There was a positive skin prick test to egg antigen. Would it be safe to administer measles-mumps-rubella (MMR) vaccine to this child? His mother does not want to consider single-dose vaccines, which are egg-free. Would it be advisable to delay his MMR until a later stage?

Response from Russell W. Steele, MD, FAAP
Professor and Vice-Chairman, Department of Pediatrics, Louisiana State University Health Sciences Center, New Orleans, and Division Head, Clinical Department of Infectious Diseases, Children's Hospital, New Orleans, Louisiana.



Well-designed studies of more than 1200 children with severe allergic reactions to eggs have clearly shown that these children can safely receive MMR vaccine [1,2]. Therefore, vaccine skin testing and desensitization are no longer recommended for children with a history of severe egg allergy, and there is no reason to delay immunization.

The 2003 Red Book [3] explains that although the MMR vaccine is produced in chicken embryo cell culture, this material does not contain significant amounts of egg white cross-reacting (ovalbumin) proteins. The Red Book Committee concluded that children with egg allergy are at low risk for anaphylactic reactions to MMR. Furthermore, because skin testing has not been shown to be predictive of reactions to MMR vaccine, it is no longer recommended before administering MMR vaccine. People with allergies to chickens or feathers have never been shown to be at increased risk for reaction to the vaccine.

However, the recommendations for influenza vaccine, which is also manufactured using egg products, are different. Children with previous anaphylactic reactions to chickens or egg protein can experience, on rare occasions, anaphylactic reactions to inactivated influenza vaccines. The Red Book [3] recommends that egg-allergic children should not receive inactivated influenza vaccine. The alternative for these patients is chemoprophylaxis.

Posted 03/02/2006

References

1. James JM, Burks AW, Roberson PK, et al. Safe administration of the measles vaccine to children allergic to eggs. N Engl J Med. 1995;332:1262-1266.
2. Kemp A, Van Asperen P, Mukhi A. Measles immunization in children with clinical reactions to egg protein. Am J Dis Child. 1990;144:33-35.
3. Pickering LK, ed. Red Book: 2003 Report of the Committee on Infectious Diseases, 26th edition. Elk Grove Village, Ill: American Academy of Pediatrics; 2003:390, 427.

Disclosure: Russell W. Steele, MD, has disclosed no relevant financial relationships.

Источник: [Ссылки доступны только зарегистрированным пользователям ] (требуется бесплатная регистрация)