The Flu Vaccine Is Safe for People With an Egg Allergy

 

In recent years, recommendations about the flu vaccine for those with an egg allergy have changed based on several studies. But many are still confused about the topic. 

All Those With an Egg Allergy Can Get the Flu Shot

It is safe for ALL people with an egg allergy to get a flu shot, even if you’ve had a severe egg allergy in the past. This includes people who have had anaphylaxis (a severe allergic reaction) to egg.

Four major medical organizations have updated their recommendations on the flu vaccine for those with an egg allergy. Their recommendations are based on studies that have shown that people with any severity of allergy to egg allergy are at no more risk of reacting to the flu shot than those without an egg allergy. These organizations are:

  • American Academy of Pediatrics (AAP)
  • The American Academy of Allergy, Asthma, and Immunology (AAAAI) 
  • The American College of Allergy, Asthma, and Immunology (ACAAI)  
  • The Centers for Disease Control and Prevention (CDC)

The AAP, AAAAI and ACAAI say the vaccine is safe to get in any setting. No special precautions are needed, like vaccine testing or extra observation. It also does not have to be done in an allergist’s office.

On Dec. 19, 2017, the AAAAI issued a press release about the guidelines, stating no special precautions are needed for flu shots for people with an egg allergy. 

The CDC says anyone who has had a reaction to egg other than hives should get the vaccine from a medical facility that can treat an allergic reaction. This implies you should go to your primary care doctor for the flu vaccine instead of a minute clinic or pharmacy. But this does not imply that an allergist is the only one who can give you a shot if you have an egg allergy with a reaction other than hives. 

The Risk of the Flu Is Greater Than the Chance of a Reaction

The chance of getting a serious illness from the flu is much, much higher than the chance of a reaction. And these serious illnesses, like pneumonia or bronchitis, can cause hospitalization or death. If your child also has a chronic disease like asthma, they are at an even higher risk for flu-caused illnesses.1

The flu vaccine reduces the risk of getting the flu by 40-60 percent. One study showed that out of 7.4 million flu shots given, there were only 10 cases of anaphylaxis. And most of these cases were not because of the egg but instead because of something else like antibiotics or other proteins in the vaccine.2

According to the CDC, about 90 percent of children who died from the flu in 2013 were not vaccinated. About 60 percent occurred in children who were high risk.3

Other Ingredients May Cause an Allergic Reaction

If your child has had an allergic reaction to the flu vaccine, other ingredients may be the cause. The flu vaccine may include antibiotics because they may be used in the making of the vaccine. Sugars, amino acids and proteins may also be used to keep the vaccine stable. The amounts of these ingredients and others are very small and well-tolerated.4 

Not All Reactions Are Allergic Reactions

Most people have no problems when they get the flu vaccine. But some may have minor reactions to the flu shot. These are signs that your immune system is working. This can include swelling on the arm, redness, headache and mild fever. These are common side effects of the vaccine and go away in a day or two.5 

When You Should Be Concerned About a Reaction

Serious reactions to the flu shot don’t happen often. But, as with any vaccine, call 911 if you notice any of these symptoms after you or your child gets the flu vaccine:

  • High fever
  • Changes in behavior
  • Trouble breathing
  • Hoarseness or wheezing
  • Swelling around the eyes or lips
  • Hives
  • Paleness
  • Weakness
  • Rapid heart beat
  • Dizziness
  • Seizure

These signs will usually occur in a few minutes to a few hours after the vaccine.

If you or your child has a had a severe reaction to the flu vaccine in the past, talk to your allergist about if it is safe for you or your child to get the vaccine in the future. Also talk them about allergy testing or if you should find other ways to reduce your risk of getting the flu. 

It’s Still Worth Getting the Flu Shot Even If the Vaccine Is Not As Effective

This year’s flu season has had a strong and early start. And this year’s vaccine is not as effective as the main flu strain that is going around. This happens sometimes because the top three predicted strains go in the vaccine. But this doesn’t mean the flu shot can’t help.

Some protection is better than none at all. The vaccine can still protect your child. A 2017 CDC study shows this. In the study, the flu vaccine reduced the risk of death by 65 percent in healthy children and by 51 percent in high-risk children.6

If you’ve been holding out on getting the flu vaccine, it’s not too late. Flu season is just starting to peak and will continue through the spring. There is still time to protect your family. The important thing to remember is an egg allergy is not a reason why you cannot get the flu vaccine and in a routine health care setting.

Medical Review December 2017.

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References
1. Cdc.gov. (2017). CDC Reports About 90 Percent of Children Who Died From Flu This Season Not Vaccinated | Spotlights (Flu) | CDC. [online] Available at: https://www.cdc.gov/flu/spotli...ldren-flu-deaths.htm [Accessed 20 Dec. 2017].
2. Cdc.gov. (2017). Vaccines: Vac-Gen/Side Effects. [online] Available at: https://www.cdc.gov/vaccines/v...side-effects.htm#flu [Accessed 20 Dec. 2017].
3. Centers for Disease Control and Prevention. (2017). Are you at high risk for the flu?. [online] Available at: https://www.cdc.gov/features/fluhighrisk/index.html [Accessed 20 Dec. 2017].
4. Centers for Disease Control and Prevention. (2017). Flu Vaccine and People with Egg Allergies. [online] Available at: https://www.cdc.gov/flu/protec...ne/egg-allergies.htm [Accessed 20 Dec. 2017].
5. Fda.gov. (2017). Common Ingredients in U.S. Licensed Vaccines. [online] Available at: https://www.fda.gov/BiologicsB...Safety/ucm187810.htm [Accessed 20 Dec. 2017].
6. Flannery, B., Reynolds, S., Blanton, L., Santibanez, T., O’Halloran, A., Lu, P., Chen, J., Foppa, I., Gargiullo, P., Bresee, J., Singleton, J. and Fry, A. (2017). Influenza Vaccine Effectiveness Against Pediatric Deaths: 2010–2014.

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Comments (4)

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Hi

To give additional context, the CDC has not updated several publications yet on vaccinations. That doesn't necessarily mean they don't agree - they just may move slower.  For the past 6 years, we have seen this to be the case specifically with this egg allergy / flu vaccine issue. The health organizations update their recommendations first based on current research, and the CDC follows within a year or two.

All major allergy organizations and the American Academy of Pediatrics all agree the flu vaccine can be given in any setting. It doesn't require supervision by your physician/allergist, etc. So, unless there are other medical conditions to consider, kids with egg allergies can get the flu shot at any location, without extra precautions.

And yes, the universal recommendations are that everyone receive a flu vaccine. Even in years when the vaccine may be less effective (due to the strains that outbreak that year), people who were vaccinated have lower rates of serious complications (or even death). Children and especially those with asthma are at great risk of flu. So, the trace contents of the flu vaccines (how much egg can be found in the vaccine) AND the threshold (how much egg does it take to trigger an allergic reaction) have been studied for years. It has been repeatedly found that the flu vaccines contain traces below the threshold. So egg allergy is no longer a reason to avoid the flu vaccine.  Now, there are other reactions that can happen (some people react to other components of the vaccine like the gelatin or antibiotics) - so anyone who has ever had anaphylaxis after receiving a flu shot should consult with physician as they may not be able to get the flu vaccine.



Hope this helps~

Kathy P.  Thank you for taking the time to respond. I appreciate it. Again, common sense is simple.  If we must go to a medical facility because there is a risk of allergic reaction for my child with egg allergies, there is still a risk posed to him that is not there for those of us without egg allergies.   It really is very simple.  I'm pro vaccine but this is clearly a push for everyone to receive the flu vaccination 

@Deb Cip - the AAP, AAAAI and ACAAI have removed the increased precautions (like vaccine testing, extra observation or being done in an allergist’s office). The CDC is has relaxed their recommendation to remove some extra precautions, but are still recommending a medical facility able to treat an allergic reaction. It's always best to discuss with your own doctor to get their recommendation based on your child's history.

We continue to be told that the flu vaccine is perfectly safe for those with egg allergies, yet they must go to a medical facility to receive it.  If it were just as safe my child could get the shot with me at CVS. 

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