WebMD Medical News
Louise Chang, MD
Oct 14, 2010 -- For years, people with egg allergy were told to avoid the flu vaccine because it contains egg protein and could trigger a reaction, but this advice no longer stands. People with egg allergies can -- and should -- get the flu shot this year, according to a new report by the American Academy of Allergy, Asthma & Immunology.
About 1.5% of young children have an egg allergy, but most will outgrow it over time, according to the Food Allergy and Anaphylaxis Network in Fairfax, Va.
Why the change?
"We now know with confidence that most people with egg allergy can receive the flu shot without reaction," says the report’s author, James T. Li, MD, PhD, an allergist at the Mayo Clinic in Rochester, Minn.
There is a "detectable, but very low" amount of egg protein in the H1N1 and seasonal flu vaccines, and studies have shown that the majority of people with egg allergy do not have an allergic reaction to the flu shot, he says.
"The number of reactions wasn't zero, but it was low, and most reactions were not serious," Li tells WebMD.
Skin testing is not necessary either unless the person with egg allergy has had a reaction to the flu vaccine in the past, Li says. The flu vaccine can be given in two doses or as a single dose if someone has an egg allergy.
Caution is still advised in certain scenarios. For example, there is still some question on whether people with severe egg allergy can receive the flu shot, he says.
"If you have egg allergy or suspected egg allergy, see your doctor, and there is a very high probability that you can receive the influenza vaccine without reaction and derive the benefits," Li says.
Elizabeth Loewy, MD, an allergist in private practice in New York City, says that she feels very comfortable giving the flu vaccine to individuals with mild egg allergy. "An egg allergy in a child is a huge predictor for asthma, and children and adults with asthma are at greater risk for complications from the flu," she says.
The new report "makes it easier for pediatricians to give kids with egg allergy their annual flu shots because it eliminates some of their concerns about reactions," she says.
Loewy currently uses a skin test, and if the person does not react, she will give the vaccine as one shot. If there is a reaction, she will break it up into two doses. She may decide to skip the skin tests in the future based on this new report, she says.
SOURCES:American Academy of Allergy, Asthma & Immunology.Elizabeth Loewy, MD, allergist, New York City.James T. Li, MD, PhD, allergist, Mayo Clinic, Rochester, Minn.Food Allergy and Anaphylaxis Network.
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