New guidelines by the American Academy of Allergy Asthma & Immunology say that individuals with egg allergies can safely receive the flu vaccine, without a skin test being performed first. Flu vaccines are grown in chicken eggs, which raised concerns about possible allergic reactions to residual egg protein. Up to now, precautionary steps were taken, which included vaccine skin testing, administration via a 2-step graded dose challenging (10%, followed by 90% of the age appropriate dose after a brief observation period), or stepwise desensitization.
This latest AAAAI paper ”offers guidance in how to evaluate and treat the patient with egg allergy who desires influenza vaccination, and outlines the latest evidence based approaches to successfully administer the vaccine.” According to the position paper:
Conclusion There has been tremendous growth over the past year in demonstrating that TIV (and H1N1) are safe for egg allergic individuals to receive. While a few concepts bear further study, such as the safety of these vaccines in individuals with severe allergy to egg, it appears that most egg allergic patients can safely receive influenza vaccination if desired. While no particular approach to administering the vaccine has been shown to be the safest and most effective, several methods for providing this service exist. Providers should no longer withhold the vaccine on account of a patient’s egg allergy, and should feel comfortable selecting one of two strategies we outline for administering the influenza