Children with Egg Allergies May Be Able to Receive Flu Vaccine

Although the 2009-2010 flu season appears to be waning in most places, research continues into the safety and efficacy of our current practices for recommending flu vaccines. At one time, children with egg allergies were advised against receiving the flu vaccine, but new research suggests that most children, unless they have a severe allergy, can still be protected from the both seasonal and H1N1 flu.

Both vaccines are made using egg protein as a base for growing the virus. As a result, the vaccine retains a tiny amount of egg in the injection.

Erica Y. Chung, MD of Children’s Hospital Boston and colleagues reviewed the charts of 171 egg-allergic patients, aged 6 months to 18 years, who were given a vaccine to protect against influenza. One group first was given a skin test to assess reaction and tolerance. The second group received a two-step, graded dose vaccine regimen.

None of the children were known to have a severe egg allergy that would result in anaphylaxis.
Of those who received the skin test before the vaccination, 95% tolerated it without any serious adverse reaction. Of the children given the graded, two-dose vaccination, 97% tolerated it safely.

The research builds on evidence from prior studies that show that the old recommendation to avoid flu vaccines when one has an egg allergy may be outdated. Two studies presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology (AAAAI) in 2008 found that, in particular, the practice of using smaller, escalating doses over a period of time may be best to build tolerance toward later receiving a full dose of the vaccine in one injection.

Parents of children with egg allergy should discuss the risks and benefits of receiving the flu vaccine each year. Pediatricians may want to first refer a patient to an allergies for testing to assess the severity of the reaction before making a decision. After a flu vaccine, the doctor may request that the patient remain at the office for 30 minutes so that medical staff can observe for a serious reaction.

Wesley Burkes, MD and professor of pediatrics at Duke University said that egg-allergic people should also be tested annually as the amount of egg protein in each year’s batch may vary.