Egg Allergy and Flu Shot

The leaves are turning, the morning grass is covered with frost. Yes, flu season is upon us! My daughter came home from school yesterday reporting, "Two of my friends got flu shots today." For her little brother, who has a severe egg allergy, I've decided against the flu shot this year. In the past, I've been a big fan. A shot in the arm beats days whimpering in bed. But in Tanner's case, I weigh the probability of him catching the flu among his duely vaccinated peers and the certainty that he will be vomiting violently from the egg. It is a contentious decision among parents of kids with egg allergies.

Eggs are used in the production of the flu shot so if you or your child is allergic to eggs, there is a chance for a reaction to the vaccine. Some health centers explicitly state, "The flu vaccine should not be taken by anyone who has a history of severe egg allergy or a previous serious allergic reaction to the flu shot."

This decision is even more delicate for parents of kids with egg allergy and asthma. If it were not for the allergy, asthma is one of the conditions that put someone in the PRIORITY GROUP for the flu shot because viral respiratory infections like the flu are a double whammy for asthmatics. They cause inflammation and mucus production in the airways and heighten the body's response to other allergens. Research has shown that the flu virus may be responsible for as many as 19% of asthma attacks. (Ford, Williams, Mannino, and Redd) According to the CDC:

People with asthma who contract the flu are at higher risk than the general population of developing complications (such as pneumonia, bronchitis, and ear infections), of time lost from work and school, of being hospitalized (especially among children younger than two, and the elderly), and of dying (especially among the elderly).

The advice that I received from our allergist and that is backed up by ACAAI is that someone who is allergic to eggs should be skin tested to the flu vaccine. If the skin test is positive, the severity of the reaction should be weighed against the risks and benefits. If you still decide to give your child the shot, it can be done in your allergist's office, where emergency treatment can be provided if necessary. Note that vaccine preparations are widely varied with significant differences in the amount of egg protein in different batches. I also found an article published from 1999 in the journal of the American Academy of Pediatrics that showed that patients with confirmed egg allergies tolerated the vaccine in 2 doses with no more than 1.2 µg/mL of egg protein, 30 minutes apart. This study was based on 83 subjects and 124 control subjects between 1994 and 1997.

The ACAAI says that 1.6% of children in the general population are allergic to eggs but "it is more common in children with other allergies." (I had to put that in quotes because I don't even know what that means!) If you or your child are newly diagnosed with an egg allergy, might I suggest two helpful references: 1) How to Manage Your Child's Life-Threatening Food Allergies and 2) Bakin' Without Eggs: Delicious Egg-Free Dessert Recipes from the Heart and Kitchen of a Food-Allergic Family.