Egg Allergy and the Flu Vaccine

Flu Vaccine and Egg Allergy

We are in the midst of one of the worst flu seasons in history. Once upon a time, people with egg allergy were advised to abstain from receiving a flu shot, because some vaccines contain egg protein, leaving them a little more vulnerable compared to the rest of the vaccinated population. In more recent years, these recommendations about the flu vaccine have changed for the better for people with egg allergy. According to recent studies, even people with confirmed egg allergy can safely have any licensed flu vaccine (i.e., any form of LAIF, ILV or RIV).

What is Egg Allergy?

Egg allergy is a medical condition that affects about 1.3 percent of children and 0.2 percent of adults. The presence of egg allergy is typically confirmed by a consistent history of adverse reactions to eggs and foods that contain eggs, as well as blood and/or skin testing for immunoglobulin E (IgE) antibodies in response (an allergic reaction) to egg proteins.

Egg allergy symptoms may range in severity as some egg-allergic individuals are able to tolerate small amounts of egg in baked products with minimal to no symptoms, while others may experience serious reactions, such as anaphylaxis, a sudden allergic reaction that can be fatal.

Previous Guidelines

Special precautions used to be recommended when it came to influenza vaccinations and people with egg allergies. People were asked if they had egg allergy prior to being given the vaccine. They were also sent to allergy specialists to receive their flu shots and were sometimes given special flu shots that did not contain any traces of egg. They also may have been asked to stay in the medical setting (doctor’s office, hospital, etc.) for longer than usual after the shot for observation.

Current Guidelines

Several organizations have recently stated that no special precautions are required for people who wish to receive the influenza vaccine, no matter how severe their symptoms of egg allergy have been. These organizations include:

  • The Joint Task Force on Practice Parameters of the American Academy of Allergy Asthma and Immunology (AAAAI)
  • The American Academy of Pediatrics (AAP)
  • The American College of Allergy, Asthma and Immunology (ACAAI)
  • The Centers for Disease Control (CDC)

 

Each of these organizations have stated that normal precautions for the administration of a vaccine should be followed, while recognizing that about one in a million vaccine doses results in serious allergic reactions and state that providers need to be prepared to both recognize and treat such reactions. Anaphylaxis can (rarely) occur regardless of the type of vaccine or whether the person has an allergy.

According to the AAAAI, AAP AND ACAAI, the flu vaccine is safe to be administered to patients in any setting, without any special precautions taken, including vaccine testing and extra observation. Additionally, these three organizations also state that a flu vaccine does not have to be given in an allergist’s office.

Matthew Greenhawt, M.D., chair of the ACAAI Food Allergy Committee, shares, “When someone gets a flu shot, health care providers often ask if they are allergic to eggs. We want health care providers and people with egg allergy to know there is no need to ask this question anymore and no need to take any special precautions. The overwhelming evidence since 2011 has shown that a flu shot poses no greater risk to those with egg allergy than those without.”

The CDC states that people with egg allergies no longer need to even be observed for 30 minutes for any allergic reaction after receiving the flu vaccine.

The CDC also states that people who have a history of egg allergy should receive the flu vaccine regardless of their reaction to eggs. This includes people who have had reactions such as hives after egg exposure as well as people with reactions involving symptoms other than hives, such as respiratory distress, angioedema, lightheadedness or even those who required emergency medical intervention and/or epinephrine. The CDC asserts that it is safe for any of these people to receive a vaccine in an inpatient or outpatient setting, but they do state that vaccine administration should be done by a health care provider who is trained to recognize and manage severe allergic reactions.

If you or your child has avoided this season’s flu vaccine because of egg allergy, it is not too late to get one. There is still time to protect you or your child.

Note: This is for informational purposes only and is not a substitute for advice, diagnosis or treatment of any conditions.

See our follow-up, Why is the Influenze Vaccine Now Safe for People with Egg Allergy?, for additional information.


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