Egg allergy no longer a contraindication to influenza vaccination

MedPage Today reported, “Having an egg allergy is no longer a contraindication to influenza vaccination, according to new guidance for the upcoming flu season from the Advisory Committee on Immunization Practices.” Under the new ACIP recommendation, “individuals with a history of allergic reactions to eating egg can receive the vaccine, with certain conditions.”

Included in the newest recommendations for vaccination in the presence of egg allergy:

  • Those with a history of hives only after exposure to egg can receive influenza vaccine, but should receive the trivalent inactivated vaccine (TIV) rather than the live attenuated influenza vaccine (LAIV), should be vaccinated by a healthcare provider who is familiar with potential manifestations of egg allergy, and should be observed for at least 30 minutes following administration.
  • People who have had more severe allergic reactions to egg should be referred to a physician with expertise in the management of allergies for further risk assessment.
  • The vaccine should be administered in settings equipped for the rapid recognition and treatment of anaphylaxis.
  • The authors noted that a previous severe allergic reaction to influenza vaccine, regardless of the component causing the reaction, is a contraindication to getting the vaccine.

As the studies conducted to date among egg-allergic individuals have all involved the inactivated influenza vaccine (TIV), that should be used instead of the live-attenuated influenza vaccine (LAIV), according to the ACIP.

In addition, egg-allergic individuals should receive the vaccine from a healthcare provider who is familiar with egg allergy and should be observed for 30 minutes after administration to look for signs of a reaction.

Overall, egg allergy occurs in no more than 1% of young children, and the vast majority will outgrow it before starting school.

In the 17 published studies on the topic, none of the more than 2,600 patients with confirmed egg allergy had a serious reaction to influenza vaccination. That included about 200 patients with severe egg allergy.

Only a small percentage of patients had mild reactions, such as hives or wheezing.

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