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Flu Vaccine Safe for Egg-Allergic Kids

Concerns About Serious Adverse Reactions Called Outdated After 2 New Studies
By
WebMD Health News
Reviewed by Louise Chang, MD

Flu Vaccine Egg Allergies

March 19, 2008 (Philadelphia) -- The flu vaccine can safely be given to kids who have an egg allergy, two new studies suggest.

Because the flu vaccine contains egg protein, the CDC doesn't recommend it for people with severe allergies to chicken eggs. And most doctors are reluctant to give flu shots to people with milder egg allergies as well.

Their concerns are outdated, says researcher Audrey Park, MD, PhD, an allergist at the Children's Hospital of Philadelphia.

"Children with egg allergies, even those who have had severe anaphylactic reactions, can safely receive influenza vaccine," she tells WebMD.

The research was presented here at the annual meeting of the American Academy of Allergy, Asthma & Immunology (AAAAI).

Building Up Tolerance

Egg allergy is very common in childhood, affecting nearly two of every 100 kids, Park says.

She and colleagues studied 45 children, aged 11 months to 9 years, who got the vaccine at their clinic in 2006. All were allergic to eggs; two had had severe anaphylactic reactions after eating them.

As recommended by the American Pediatrics Association, the kids were given skin prick tests to determine if they were allergic to the vaccine.

Children who were not allergic were given a full dose of the flu shot.

Kids who were allergic to the vaccine were injected with three to four smaller, escalating doses until they had received the full dose. The idea is that by starting with small amounts of the allergen and building up, the patient becomes desensitized and tolerance develops, Park explains.

Only Mild Allergic Reactions Observed

Park says that two-thirds of the children had no adverse reactions at all.

All but one of the other children had mild reactions at the site of the injection, such as itchiness or redness. One child developed diffuse hives over the whole body.

The second study involved 115 children, aged 9 months to 13 years, with egg allergies who got flu shots. Two-thirds of them also had asthma.

About half got the vaccine as a single dose.

None of the children developed serious allergic reactions, says researcher Simon Hotte, MD, of Montreal Children's Hospital. Six kids had minor reactions at the injection site that quickly went away.

Fewer Than 30% of Kids Vaccinated

Park says she hopes the results will persuade more parents to get their kids vaccinated.

Currently, fewer than 30% of children are inoculated, she says.

The flu can kill a child with a chronic health condition like asthma, Park says.

"If your child has egg allergies, ask your primary care physician for a referral to an allergist for skin testing and desensitization, if needed," she says.

Wesley Burkes, MD, chairman of the committee that chose which studies would be highlighted at the meeting and a professor of pediatrics at Duke University, Durham, N.C., says the results are very promising.

"We shouldn't be telling egg-allergic patients -- children or adults -- that they can't take the vaccine," he tells WebMD.

"By doing skin testing or other diagnostic tests when patients come in, we can determine on an individual basis who can tolerate the whole dose at once and who can't. Egg-allergic individuals can safely get the vaccine with appropriate management," he says.

Burkes adds that egg-allergic people should be tested annually, as the amount of egg protein in each year's batch may vary.

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