Egg allergies and the flu vaccine: What do I need to know?

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Desmond Sewell, 12, receives a vaccination in Los Angeles.

For some parents of children with egg allergy, the flu vaccine has been cause for concern. About 3 percent of U.S. children are allergic to eggs, with symptoms ranging from the relatively mild, such as hives, to the more severe, which include persistent vomiting, respiratory distress, and anaphylaxis. Though the flu vaccine is processed with egg-based technology, it contains only a tiny amount of egg protein. Until this year, the recommendation for giving the flu vaccine to children with more severe egg allergy was to administer it in an allergist’s office and to observe the child for 30 minutes following administration to monitor for reaction.

A recent study conducted by the Centers for Disease Control and Prevention found that the incidence of severe reaction to the flu vaccine among egg-allergic and non-allergic children was literally one in a million.

Given those findings, the recommendations have been revised so that children with egg allergy can be safely vaccinated in any inpatient or outpatient setting where the provider feels comfortable recognizing and managing allergic reactions. In addition, the prolonged waiting period of 30 minutes has been deemed unnecessary. This is true for both the injectable form of the vaccine and the FluMist nasal spray vaccine. A CDC advisory committee recommended earlier this year that FluMist, the nasal spray influenza vaccine, not be used during the 2017-18 season because the shot was found to be more effective.

This is good news, giving parents of kids with egg allergy greater peace of mind and more options for vaccination as we head into flu season. The majority of reactions occur soon after the vaccine is given — in less than 20 minutes. Based on the study results, severe reactions are extremely unlikely.

We urge everyone who is eligible to get the flu vaccine, even egg-allergic children. Complications of the influenza virus include pneumonia, inflammation of the organs, sepsis or even death. The flu vaccine helps to decrease your risk of contracting the influenza virus and spreading the virus in your community.

Babies younger than 6 months of age should not receive the flu vaccine. Children who have had a severe reaction to the flu vaccine in the past should be seen by an allergist for evaluation and management.

For further information, here’s an article about egg allergy and the flu vaccine from American Academy of Allergy, Asthma & Immunology website.

Hillary Gordon, MD, is a pediatric allergist who practices at Nemours/Alfred I. duPont Hospital for Children in Wilmington, DE, at Nemours sites in Concordville, PA and on the Thomas Jefferson University campus in Philadelphia.