Do individuals with atopic dermatitis have an abnormal response to influenza vaccination?

Published online: February 13, 2017

Atopic dermatitis -a long-term (chronic) skin disorder that involves scaly and itchy rashes- is a very common health problem. The skin of patients with atopic dermatitis is particularly prone to infections by bacteria like Staphylococcus aureus. The intradermal seasonal influenza vaccine has been widely used since 2011 but it is not known if this vaccine is equally immunogenic in individuals with and without atopic dermatitis. It is also not known if patients with atopic dermatitis respond differently to intradermal and intramuscular influenza vaccines.

In the article recently published in The Journal of Allergy & Clinical Immunology (JACI), Leung and colleagues characterized the antibody responses to influenza vaccination in patients with atopic dermatitis, including a subset of atopic dermatitis patients with skin colonization by Staphylococcus aureus.

Intradermal influenza vaccine was administered to patients with moderate to severe atopic dermatitis and to non-atopic individuals. Intramuscular infuenza vaccine was also administered to a group of patients with atopic dermatitis. The researchers compared the antibody responses between patients with atopic dermatitis and non-atopic individuals vaccinated with the intradermal influenza vaccine. They also compared the antibody responses in patients with atopic dermatitis receiving intradermal versus intramuscular vaccine.

The authors found no differences in vaccine response to intradermal influenza vaccine between patients with atopic dermatitis and non-atopic individuals. Additionally, the authors found no difference in vaccine response between patients with atopic dermatitis receiving the influenza vaccine intradermally or intramuscularly. Interestingly, patients with skin colonization by Staphylococcus aureus developed a lower response to 2 of the 3 influenza strains in the vaccine but only when the vaccine was administered intradermally.

Intramuscular influenza vaccination  may be recommended in patients with atopic dermatitis given that the majority of patients with atopic dermatitis have skin colonization by Staphylococcus aureus.

The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.

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