Last September, Pediatric Alliance allergist Dr. Deborah Gentile reviewed updated guidelines from the Centers for Disease Control and Prevention (CDC) and Advisory Committee on Immunization Practices (ACIP) regarding precautions for giving egg-allergic people influenza vaccines. “Only about 1.3% of all children and 0.2% of all adults are allergic to eggs,” Dr. Gentile reminded us. A history of hives after eating eggs required no special precautions for administration of a flu vaccine. More careful consideration was thought to be required for those with more severe symptoms of egg allergy:
Persons who report having had reactions to egg involving symptoms other than hives, such as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who required epinephrine or another emergency medical intervention, may similarly receive any licensed and recommended flu vaccine (i.e., any form of IIV or RIV) that is otherwise appropriate for the recipient’s age and health status. The selected vaccine should be administered in an inpatient or outpatient medical setting (including, but not necessarily limited to hospitals, clinics, health departments, and physician offices). Vaccine administration should be supervised by a health care provider who is able to recognize and manage severe allergic conditions.
The only contraindication left for receiving a flu vaccine is a previous severe reaction to flu vaccine, regardless of the ingredient responsible — an exceedingly rare event. For everyone else, Jamie Ducharme has some very good news:
The updated practice parameters, which were written by American Academy of Allergy, Asthma and Immunology Food Allergy Committee Chair Matthew Greenhawt, are based on dozens of studies that suggest the tiny amounts of egg protein found in a flu shot are not enough to trigger a dangerous reaction, even in people with a severe allergy.
People do not need to see an allergist before getting a flu shot, seek out egg-free formulas or submit to longer-than-normal observation periods after vaccination, the guidelines say. Doctors don’t even need to ask about an egg allergy before giving the injection, the paper adds.
Now people with egg allergies can receive their annual flu vaccines sunny side up!
*** Beginning January 22, 2018, Pediatric Alliance and our pediatric colleagues from around the United States are participating in an AAP-sponsored immunization advocacy campaign on social media. Please follow all our social media posts during this project on Facebook and Twitter.