Egg Allergies? Fear Not the Flu Shot

Flu vaccine safe for children with egg allergies in new recommendations

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Everyone is urged to get a flu shot, but what should you do if an allergy might interact with the vaccine? Risk the flu or risk the allergic reaction? For many patients, these concerns have now been addressed.

A new article updating practice recommendations has eased flu vaccine concerns and precautions for those with egg allergies.

The American College of Allergy, Asthma and Immunology (ACAAI) reported that the benefits of receiving a flu shot outweigh the risks, even for those with egg allergies.

"Talk to your doctor about vaccinations."

The concern regarding influenza vaccinations for those with egg allergies developed because some flu vaccines are created using egg protein.

Previous guidelines recommended that those with egg allergies be observed for 30 minutes after receiving a flu vaccine to watch for any allergic reaction, the authors of this new update explained. It was also suggested that people with severe egg allergies receive their flu vaccine in an allergist's office.

However, these guidelines have now been eased. The update, led by John M. Kelso, MD, of the Division of Allergy, Asthma and Immunology at Scripps Clinic in San Diego, California, explained that these special precautions recommending medical setting and waiting period (beyond those of any normal vaccine) are not warranted.

The authors cited several studies involving over 4,000 egg allergic participants that found no severe cases of allergic reactions to the inactivated influenza vaccine (IIV), even among those with a severe egg allergy.

"Both authors independently concluded that the risk of an adverse reaction to inactivated influenza vaccine (IIV) is exceptionally low for any patient with any severity of egg allergy and that these patients can be vaccinated safely with a single dose of IIV, without requiring administration by an allergist, which otherwise poses an unnecessary barrier to immunization and is not justified based on available safety data," Dr. Kelso and team wrote.

"People with egg allergy are not at any additional risk of having a reaction when given the flu vaccine even though the vaccine may contain some amount of egg protein," ACAAI explained.

However, the organization noted, "As with any vaccine, all personnel and facilities administering flu shots should have procedures in place for the rare instance of anaphylaxis, a severe life-threatening allergic reaction."

ACAAI estimated that about 1.6 percent of children have an egg allergy (making it one of the most common food allergies) and noted that food allergies are more common in children than adults. 

In an interview with dailyRx News, Alexandra M. Reimann, ND (Naturopathic Physician), a primary care physician at Valhalla Wellness in Las Vegas, recommended still using a certain amount of caution.

"Though these vaccines are generally considered safe for people with egg allergies, caution is still recommended," said Dr. Reimann. "An alternative includes the flu vaccine that doesn't contain egg protein."

Dr. Reimann explained that other precautions include skin tests to check for reactions to egg protein, waiting in the doctor's office for 30 minutes after a shot or splitting the vaccine between two injections. 

"Ten percent of the vaccine can be given in one injection, then the remaining 90 percent of the vaccine in a second injection if there's no reaction," Dr. Reimann explained. 

"The best course is to discuss your personal situation with your health care provider, to see if you both believe the benefits of receiving flu vaccine outweigh any individual risks," Dr. Reimann told dailyRx News.

The update is endorsed by the Joint Task Force on Practice Parameters from ACAAI and the American Academy of Allergy, Asthma, and Immunology (AAAAI).

The article was published in the October issue of ACAAI's Annals of Allergy, Asthma and Immunology. No conflicts of interest were reported.

Review Date: 
October 1, 2013
Last Updated:
January 13, 2015