Adverse events after flu vaccination in patients with immune disorders.

In one case, an 89-year-old Chinese Indonesian male with eczema and allergic rhinitis was injected with the seasonal flu vaccine (not the H1N1 influenza vaccine) and a pneumococcus vaccine on 14 November 2009. His eczema was in remission at the time of injection. One week later he developed a skin rash that became progressively more severe, involving both upper limbs (Fig 1), both knees, and his right ankle. His trunk was also itchy but he had no rash. He had been taking a number of medicines—aspirin, simvastatin, lisinopril, atenolol, isorbide mononitrate, frusemide, natrilix SR, colchine, voltaren—for several years, and reported no side-effects. When his rash was most pronounced there were two significant laboratory findings. His eosinophil count rose from 3.8% in a previous test to 18.7% and his immunoglobulin E was 3435.1 ng/mL (reference level, 0.2-379.2 ng/mL). He improved with topical steroids, oral anti-histamines, and suspension of his other medications for a week.