Egg allergy is a common problem affecting young children especially. There has been much debate over the past several decades on how to approach the subject of influenza vaccination in children with egg allergy.
Because of concern regarding the egg protein content in the influenza virus vaccine, pediatricians have in the past typically taken a conservative approach of avoiding influenza vaccination in egg-allergic patients. Subsequently, it was shown that the influenza vaccine could be safely administered to patients who had negative skin testing to the vaccine. Most recently, studies have demonstrated a low risk of giving the vaccine either in divided doses or as a single dose in a controlled setting without the need for skin testing.
In considering vaccination in a patient with a history of egg allergy, several factors should be weighed, including the severity of the egg allergy, the egg content of vaccines, and the setting of vaccine administration. However, it appears that the risk of anaphylaxis to the influenza vaccine in patients with egg allergy may be much lower than previously thought, suggesting that in many cases skin testing may not be necessary.
Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA
Correspondence to David A. Gruenberg, MD, Assistant Professor of Medicine and Pediatrics, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03766, USA Tel: +1 603 653 3827; e-mail: David.A.Gruenberg@hitchcock.org