Update on Egg Allergy and Influenza Vaccine (Nov 2011)

Based on a review of recent studies, and consistent with newly published guidelines, John M. Kelso, MD, FAAAAI, James T. Li, MD, PhD, FAAAAI, and Matthew J. Greenhawt, MD, MBA, have authored updated recommendations that all egg allergic patients should receive the influenza vaccine.

The risk of an allergic reaction to influenza vaccine in patients with egg allergy is very low, likely due to the very low amount of ovalbumin in the vaccines. Any such theoretical risk is far outweighed by the very real risk of such patients remaining unvaccinated. Thus all patients with egg allergy of any severity, including anaphylaxis, should receive influenza vaccine.

Skin testing with the vaccine and dividing the dose are not necessary. The injectable vaccine should be administered in a medical setting where anaphylaxis can be recognized and treated should it occur.

For those with a history of hives only after egg ingestion, the vaccine can be administered in the primary care provider's office. For those with more serious reactions to egg ingestion, the vaccine should be administered in an allergist's office.

The full paper is available here.