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Flu Vaccine and the Egg Allergic Child

Every year the flu vaccine is produced using an egg based culture. This means the flu vaccine contains a small amount of egg protein which will vary year to year and by the manufacturer. For many years, children with egg allergy were denied the flu vaccine due to concerns of a possible allergic reaction. This was a real shame since many children with egg allergy are in high risk groups for the flu being < 2 years of age and many have asthma. Over the past few years, we have begun to offer the flu vaccine to the egg allergic child by first performing an allergy skin test to a diluted form of the vaccine. If the skin test was negative, the vaccine was administered. In our clinic by utilizing this approach, we have safely and successfully immunized hundreds of egg allergic children over the past few years.

In 2011, the guidelines have been revised and the initial step of the allergy skin test to the vaccine is no longer necessary.

Our approach to the child with egg allergy requiring the flu vaccine:
• a thorough clinical history on the severity of the egg allergy is obtained and reviewed.
• if the initial egg reaction was not severe or if the child is currently ingesting baked egg products, a single dose of the full vaccine is given.
• for the rare case of a child with a severe egg reaction, the vaccine is split into two doses given 30 minutes apart
• all children are observed for 30 minutes following the vaccine

By following this approach for the fall of 2011, we at The Food Allergy Specialists have safely immunized nearly 100 egg allergic children.

Resources

See a recent interview on KVUE on egg allergy and flu shots
www.kvue.com/video

American College of Allergy, Asthma, and Immunology
www.acaai.org

The Food Allergy Network
www.foodallergy.org

American Academy of Allergy, Asthma, and Immunology
www.aaaai.org