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Egg Allergy and the Seasonal and H1N1 Influenza Vaccines
The yearly flu vaccines are recommended for all children over age 6 months. These vaccines contain a very small amount of egg protein, and this raises concerns about giving them to children with egg allergy. For many years, physicians and various medical societies and expert panels recommended avoidance of these vaccines in children with severe egg allergy. This thinking has been changing.
Over the years, several vaccine manufacturers have begun to label the vaccines with the amount of egg that they contain, and it appears that some have much less egg protein than they had many years ago. Additionally, studies have emerged showing that the vast majority of children with egg allergy, even those with “severe” egg allergy, tolerate the vaccines.
The focus of avoiding these vaccines has primarily been aimed at children with “severe” egg allergy. This means that a child with “mild” egg allergy could get the vaccine. It is recognized, however, that there may be difficulty in deciding who has a mild compared to severe egg allergy.
Various professional organizations and individual allergists have suggested a variety of approaches to increase the safe use of these vaccines for children with egg allergy. The advice varies from selecting a vaccine labeled as being low in egg protein and injecting it in the usual manner without any prior testing, to performing allergy skin tests with the vaccine and using the results for deciding upon administering the vaccine. In some cases, the physician will divide the vaccine dose into a number of smaller injections. All of the experts recommend that the vaccine be given under supervision of a physician who is prepared to treat any allergic reactions.
The good news is that studies thus far show that reactions are very uncommon, and if they occur are usually quite mild, such as mild swelling at the site of injection.
While the seasonal and H1N1 influenza vaccines are recommended for all children, they are particularly important for children with asthma who are susceptible to more serious illness due to the flu. Many children with egg allergy also have asthma, making vaccination particularly important for them. Professional organizations are recognizing that the low risk of vaccination reactions is overshadowed by the great benefits of vaccination and they are presenting options to follow for giving these vaccines to everyone with egg allergy.
As new studies emerge, and as manufacturers label and test their products for egg content, it is likely that guidelines for administering these vaccines will be more and more liberal in encouraging vaccination with less concern, less testing, and in single doses without using multiple smaller shots that are uncomfortable. Talk to your pediatrician and allergist and strongly consider these important vaccines for your child with egg allergy.
FAAN's and the Food Allergy Initiative's Medical Advisory Boards have both approved this statement.
About FAAN
Founded in 1991, FAAN (The Food Allergy & Anaphylaxis Network) is the world leader in information, resources, and programs for food allergy, a potentially life-threatening medical condition that afflicts approximately 12 million Americans, or one out of every 25. A nonprofit organization based in Fairfax, Va., FAAN has approximately 25,000 members in the U.S., Canada, and 58 other countries. It is dedicated to increasing public awareness of food allergy and its consequences, to educating people about the condition, and to advancing research on behalf of all those affected by it. FAAN provides information and educational resources about food allergy to patients, their families, schools, health professionals, pharmaceutical companies, the food industry, and government officials. For more information, please visit FAAN at www.foodallergy.org.
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