Egg allergy and flu shots – video link

Dr Rodney Ford on YouTube

Dr Rodney Ford on YouTube

 Egg allergy and flu shots – can they go together?
Every day we are getting questions at our allergy clinic from patients with children with egg allergy. They are asking “Dr Ford, can my egg allergic child have a flu vaccine?”

Egg allergy and flu shots – video link

As you know, flu vaccine does have a tiny amount of egg in it (just a tiny, tiny, intsy wintry bit) and they has been theoretical concern that egg allergic children, when injected with this flu vaccine, would have an adverse reaction. Well, they don’t. There have been over 2000 cases now of children with egg allergy vaccinated with flu vaccine without any problems. Some of them get a bit of a local swelling, a bit of redness, maybe even a bit of a hive or two around the injection site, but no serious reaction. It is thought that the serious flu infection is a much worse thing than having the vaccine.
So, the recommendation is: if your child has egg allergy, you can nevertheless go ahead and have  flu vaccine.  It is safe.

New information indicates that egg-allergic patients can now get flu shots.

About 20% of the population comes down with influenza every year, and vaccination is an effective strategy to prevent it. But patients with egg allergy have been told that they couldn’t be vaccinated because chicken eggs are used in making vaccine. Consequently, there was theoretical concern that traces of egg protein could trigger a serious allergic reaction.

But new data indicate differently.[1-4] At least 17 studies of more than 2600 egg-allergic patients showed no serious reactions, including respiratory distress and hypotension. The only reactions were minor, such as hives and mild wheezing.

The likeliest reason for this surprising lack of reaction is the tiny amount of leftover egg protein in the vaccine. There is also good news for the healthcare professional who administers flu vaccines. No skin tests are needed. The results aren’t predictive, and there is no need to divide the dose. Single-dose studies support giving the entire vaccine dose at one time.

Caveats
There are some special caveats. Egg-allergic patients must get the inactivated flu shot because this is what has been used in studies. They cannot get the nasal flu vaccine. Anyone giving vaccinations should be familiar with egg allergy. After administering the shot, patients should be observed for 30 minutes.

The bottom line is that allergy experts have changed their tune. They now say it is safer for egg-allergic patients to get vaccinated than to risk getting the flu.[5]

Having said all of this, children with big skin test reactions to egg-white (15 mm or more) might be best to avoid the flu vaccine this year.

By Rodney Ford    2013

References
1. Kelso JM. Administration of influenza vaccines to patients with egg allergy: update for the 2010-2011 season. J Allergy Clin Immunol. 2010;126:1302-1304.
2. Greenhawt MJ, Li JT, Bernstein DI, et al. Administering influenza vaccine to egg allergic recipients: a focused practice parameter update. Ann Allergy Asthma Immunol. 2011;106:11-16.
3. Chung EY, Huang L, Schneider L. Safety of influenza vaccine administration in egg-allergic patients. Pediatrics. 2010;125:e1024-1030.
4. Zeiger RS. Current issues with influenza vaccination in egg allergy. J Allergy Clin Immunol. 2002;110:834-840.
5. Centers for Disease Control and Prevention. Prevention and control of influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices (ACIP), 2011. MMWR Morbid Mortal Wkly Rep. 2011;60(early release):1-6. Available at: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm60e0818a1.htm?s_cid=mm60e0818a1_w Accessed August 11, 2011.

By Rodney Ford