Vaccination of people with suspected egg allergy is safe and feasibleBMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d5780 (Published 13 September 2011) Cite this as: BMJ 2011;343:d5780
- Christopher J A Duncan, research fellow1,
- Andrew D McCallum, specialty registrar in infectious diseases1,
- Rona MacDonald, specialty registrar in genitourinary medicine1,
- Michael E Jones, consultant physician1
Rolfe and Sheikh cite recent guidelines recommending that all egg allergic children should receive the measles, mumps, and rubella vaccine.1 2 These guidelines also recommend that an allergy specialist should guide the provision of other egg containing vaccines (including flu and yellow fever), for which the risk-benefit is less clear.2
Several life threatening travel related diseases are preventable by vaccines containing egg antigen, but limited data on the safety of their administration to egg allergic individuals are available to inform risk-benefit analysis.3 4
From 2000 to 2010 we immunised 14 people with suspected egg allergy aged 18-43 years, using a clinical protocol based on risk assessment (clinical presentation and radioallergosorbent test (RAST) for egg white specific IgE) and supervised immunisation depending on risk (possibly including prophylactic intravenous cannulation with or without 20% intradermal test doses).
Eleven of these people underwent RAST (4/11 were positive) and 12 were prophylactically cannulated. Three received an intradermal test dose. Of these, one RAST positive individual had an immediate urticarial reaction to the test dose, precluding full dose administration. Another RAST positive individual developed a minor local reaction that did not prohibit full dose administration. Of the 14 egg allergic patients, 10 (including 2/4 with positive RAST) received egg containing vaccines without major adverse events; four received vaccines that did not contain egg.
Overall, the frequency of serious allergic reactions was low in this cohort with suspected egg allergy referred for specialist guided immunisation. Under appropriately supervised and monitored conditions, people with egg allergy may be vaccinated without excessive risks, so egg allergy is not necessarily a barrier to receiving egg containing vaccines.
Cite this as: BMJ 2011;343:d5780
Competing interests: None declared.