Intramuscular Flu Vaccination Recommended for Patients With Eczema

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Intramuscular rather than intradermal flu vaccination is preferred in patients with <i>S aureus</i> colonized atopic dermatitis.
Intramuscular rather than intradermal flu vaccination is preferred in patients with S aureus colonized atopic dermatitis.

HealthDay News — For patients with moderate/severe atopic dermatitis (AD), those colonized with Staphylococcus aureus have a reduced immune response to intradermal influenza vaccination, according to a study published in the Journal of Allergy and Clinical Immunology.

Donald Y.M. Leung, MD, PhD, from National Jewish Health in Denver, Colorado and colleagues compared antibody responses to intradermal vaccination among patients with moderate/severe AD vs non-atopic participants in an open-label study conducted at 5 sites during the 2012 to 2013 influenza season. A total of 347 participants were included and followed for 28 days after vaccination.

The researchers found that seroprotection rates for influenza B, H1N1, and H3N2 did not differ between participants with AD and non-atopic participants receiving intradermal vaccination, or for participants with AD receiving intradermal and intramuscular vaccination. Compared to noncolonized participants with AD, those with S aureus colonization experienced lower seroprotection and seroconversion rates and lower hemagglutination-inhibition titer geometric mean fold increase against influenza B and lower seroconversion rates against influenza H1N1 after intradermal, but not intramuscular, vaccination.

"Because most patients with AD are colonized with S aureus, intramuscular influenza vaccination should be given preference in these patients," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.


Leung DY, Jepson B, Beck LA, et al. A clinical trial of intradermal and intramuscular seasonal influenza vaccination in patients with atopic dermatitis [published online February 13, 2017]. J Allergy Clin Immunol. doi: 10.1016/j.jaci.2016.12.952

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