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CompletedNCT02111512SNIFFLE-2Updated Aug 10, 2020

Safety of Nasal Influenza Immunisation in Egg Allergic Children - The SNIFFLE 2 Study

A Phase 4 interventional study of Administration of Live attenuated influenza vaccine (LAIV) in Egg Hypersensitivity, sponsored by University Hospital Southampton NHS Foundation Trust. Completed at 29 sites in United Kingdom. Open to participants aged 2 Years to 17 Years. Per ClinicalTrials.gov, last updated 2020-08-10.

Sponsored by University Hospital Southampton NHS Foundation Trust · Phase 4, Interventional, and Treatment

Phase
Phase 4
Study type
Interventional
Enrollment
779
Allocation
Not applicable
Ages
2 Years to 17 Years
Sex
All
01

Study summary

Egg allergy is common in early childhood, affecting at least one in 50 preschool children. Influenza ("'flu") vaccines contain egg protein, as the vaccine is cultured in hen's eggs. There is robust data to support the safety of influenza vaccines (containing low or negligible amounts of egg protein) in patients with egg allergy.

A new influenza vaccine, known as LAIV (Live Attenuated Intranasal Vaccine) has recently been approved by a number of licensing boards and is given by a spray into the nose. This new vaccine has been available in the United States for several years and is highly effective and against influenza infection, with an excellent safety profile in children without egg allergy. However, LAIV is also grown in hen's eggs and contains egg protein, and there are NO published data on the safety of LAIV in egg-allergic children. In SNIFFLE 1 Study, 433 doses were given to 282 egg-allergic children; data is currently being analysed.

The objective of this multicentre study is to further assess the safety of intranasal LAIV in egg-allergic children, in order to demonstrate that these children can safely be given the new LAIV within a primary care health environment.

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Conditions studied

  • Egg Hypersensitivity

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03

In context

Egg Hypersensitivity

38 studies on the registry are indexed under Egg Hypersensitivity; 9 are open to participants now.

This study's enrollment of 779 is above the median of 73 across 27 interventional studies indexed under Egg Hypersensitivity.

Browse Egg Hypersensitivity studies →

Lead sponsor

University Hospital Southampton NHS Foundation Trust is the lead sponsor of 150 studies on the registry; 35 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
2 Years to 17 Years
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Aged 2 - 17 years old
  • Physician-diagnosis of egg allergy

Exclusion criteria

Exclusion Criteria:

  1. Clinical resolution of egg allergy
  2. to LAIV (notwithstanding allergy to egg protein):

    • to the active ingredients, gelatin or gentamicin (a possible trace residue)
    • Previous systemic allergic reaction to LAIV
    • Previous allergic reaction to an influenza vaccine (not LAIV) is a relative contra-indication, which must be discussed with the site PI to confirm patient suitability
    • Children/adolescents who are clinically immunodeficient due to conditions or therapy such as: acute and chronic leukaemias; lymphoma; symptomatic infection; cellular immune deficiencies; and high-dose . NB: LAIV is not contraindicated for use in individuals with asymptomatic HIV infection; or individuals who are receiving topical/inhaled corticosteroids or low-dose systemic corticosteroids or those receiving corticosteroids as replacement therapy, e.g. for adrenal insufficiency.
    • Children and adolescents younger than 18 years of age receiving salicylate therapy because of the association of Reye's syndrome with salicylates and wild-type influenza infection.
  3. Contraindication to vaccination on that occasion, due to child being acutely unwell:

    • Febrile ≥38.0oC in last 72 hours
    • Acute wheeze in last 72 hours requiring treatment beyond that normally prescribed for regular use by the child's treating healthcare professional
    • Recent admission to hospital in last 2 weeks for acute asthma
    • Current oral steroid for asthma exacerbation or course completed within last 2 weeks
Terms in these criteria, in plain language(5)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

05

Study design

Phase
Phase 4
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
779 participants (actual)

Study arms

  • Other
    Egg allergic children

    Children with a physician diagnosis of egg allergy will be recruited to receive the intranasal LAIV as part of a safety surveillance study

    Drug: Administration of Live attenuated influenza vaccine (LAIV)

Interventions

  • DrugAdministration of Live attenuated influenza vaccine (LAIV)
06

What researchers measure

Primary outcomes

  1. Incidence of allergic reaction to nasal influenza vaccination using a Live Attenuated Influenza Vaccine (LAIV) in egg-allergic children

    Time frame: Within 2 hours of vaccine administration

Secondary outcomes

  1. Incidence of delayed symptoms up to 72 hours after nasal influenza vaccination with LAIV in egg-allergic children

    Time frame: 72 hours after vaccine administration

  2. Asthma control test

    To assess for a change in asthma control (by validated questionnaire) pre and 4 weeks post LAIV immunisation.

    Time frame: 4 weeks post LAIV

Other outcomes

  1. Incidence of immediate allergic reaction to LAIV in the subgroups described below.

    1. By age group 2-5, 6-11, 12-17 years 2. Children with a clinician-assessed history of reaction to egg in the previous 12 months 3. Children with evidence of \>95% likelihood of egg allergy (as per published criteria) within the past 3 months 4. Children with evidence of \>95% likelihood of egg allergy (as per published criteria) within the past 12 months 5. children with a previous history of anaphylaxis to egg protein 6. children who have reacted previously to airborne traces of egg 7. children who have egg allergy but are tolerant of baked egg 8. Children who have previously received influenza vaccine 9. Presence of physician-diagnosed asthma / recurrent wheeze

    Time frame: Within 2 hours of vaccine administration

07

Study locations

29 sites
  • Ulster Hospital
    Belfast, Northern Ireland, United Kingdom
  • Royal United Hospital Bath NHS Trust
    Bath, United Kingdom
  • Sandwell General Hospital
    Birmingham, United Kingdom
  • Bristol Royal Hospital for Children
    Bristol, United Kingdom
  • Cambridge University Hospitals NHS Foundation Trust
    Cambridge, United Kingdom
  • Royal Hospital for Sick Children
    Edinburgh, United Kingdom
  • James Paget University Hospitals NHS Foundation Trust
    Great Yarmouth, United Kingdom
  • Wye Valley NHS Trust
    Hereford, United Kingdom
  • Cambridgeshire Community Services NHS Trust (Hinchingbrooke Hospital)
    Huntingdon, United Kingdom
  • Leeds Children's Hospital
    Leeds, United Kingdom
  • Leicester Royal Infirmary
    Leicester, United Kingdom
  • Alder Hey Children's Hospital
    Liverpool, United Kingdom
  • Barts Health NHS Trust
    London, United Kingdom
  • Evelina Children's Hospital
    London, United Kingdom
  • Imperial College Healthcare NHS Trust (St. Mary's Hospital)
    London, United Kingdom
  • Kings College Hospital NHS Foundation Trust
    London, United Kingdom
  • London St George's Hospital
    London, United Kingdom
  • Royal Free London NHS Foundation Trust
    London, United Kingdom
  • University College London Hospitals NHS Foundation Trust
    London, United Kingdom
  • Luton and Dunstable Hospital
    Luton, United Kingdom
  • Manchester Royal Children's
    Manchester, United Kingdom
  • Newcastle Freeman Hospital
    Newcastle, United Kingdom
  • Oxford
    Oxford, United Kingdom
  • Lancashire Teaching Hospitals NHS Foundation Trust
    Preston, United Kingdom
  • Sheffield Children's Hospital NHS Foundation Trust
    Sheffield, United Kingdom
  • Shrewsbury and Telford Hospital NHS Trust
    Shrewsbury, United Kingdom
  • University Hospitals Southampton NHS Foundation Trust
    Southampton, United Kingdom
  • Warrington & Halton Hospitals NHS Foundation Trust
    Warrington, United Kingdom
  • Hampshire Hospital NHS Foundation Trust
    Winchester, United Kingdom
08

References and documents

Publications

  • Turner PJ, Southern J, Andrews NJ, Miller E, Erlewyn-Lajeunesse M; SNIFFLE-2 Study Investigators. Safety of live attenuated influenza vaccine in young people with egg allergy: multicentre prospective cohort study. BMJ. 2015 Dec 8;351:h6291. doi: 10.1136/bmj.h6291. PubMed 26645895 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Aug 10, 2020, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02111512
Collaborators
Imperial College London, Public Health England
Responsible party
Paul Turner (MRC Clinician Scientist, Imperial College London) — Principal investigator
First posted
Apr 11, 2014
Start date
Sep 2014
Primary completion
Feb 2015
Completion
Mar 2015
Last update
Aug 10, 2020

Study contacts

Mich Erlewyn-Lajeunesse, DM FRCPCH
principal investigator · University Hospitals Southampton NHS Foundation Trust
Paul J Turner, FRACP PhD
principal investigator · Imperial College London

Oversight

Data monitoring committee
Yes
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Aug 2020. You cannot join it, but the record below documents what was studied.

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