‘Red Book’ Update

Abstract

UPDATE The Red Book Committee met on May 10, 1982 and considered a number of issues, including: 1. The 1982 edition (19th) of the Red Book has been distributed beginning on June 4, 1982. We welcome comments and suggestions for the 20th edition. 2. IMPORTANT REVISION IN RED BOOK RECOMMENDATIONS: After the Committee meeting it came to our attention that three children who had anaphylactoid reactions to egg ingestion experienced immediate allergic reactions to chick-embryo-grown live measles virus vaccine; two had difficulty breathing and one had hypotension. Persons who are egg-allergic but do not have a history of anaphylactoid reactions appear to be at little or no risk from live measles virus (LMV) vaccine (See Morbidity Mortality Weekly Rep 31:217-231, May 7, 1982). Because previous experience indicated no adverse reactions in egg-allergic children given vaccine prepared in chick embryo tissue culture, the 1982 Red Book contains the following statement: The vaccine currently used in the United States is prepared in chick embryo tissue culture by inoculation with a further attenuated passage of the Edmonston B strain of measles virus. This preparation is virtually devoid of allergenic substances derived from the chick embryo cell cultures used for growth of the live vaccine viruses. However, there is a remote potential risk of hypersensitivity reactions in patients allergic to eggs, chicken, or chicken feathers; large scale use of the vaccine for more than a decade has resulted in only rare, isolated reports of minor allergic reactions. In a study in which children known to be allergic to eggs, chicken, or chicken feathers were vaccinated with a chick embryo cell culture-derived vaccine, no allergic reactions were observed.