Flu Vaccine and Egg Allergy

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Influenza vaccine (injectable and nasal) is grown on chick embryos. For decades, the thinking was that those allergic to eggs could have allergic reactions to the vaccine. But when you withhold the vaccine, thousands of egg-allergic patients come down with the flu. Yes, we have medicines to treat the flu like Tamiflu, but 1) we have begun seeing flu strains resistant to Tamiflu, and 2) Tamiflu is not a panacea (instead of feeling like you were run over by a truck for five days, you feel that way for four days).

Several years ago, state-of-the-art advice from a board-certified allergist was to get allergy skin tested with the flu vaccine. If the skin test was negative, we would give you a test dose with 10 percent of the flu vaccine. If you were OK 30 minutes later, we would give you a second shot with the other 90 percent of the dose and then observe you for 30 minutes.

That allergy test is no longer necessary. Bottom line – it is almost always safe for those allergic to eggs to get the flu vaccine, even for people who have the most severe reactions to eggs (e.g., anaphylaxis). A 2011 study included 27 young children (under 3 years old) who had anaphylaxis from eggs; none of them had serious reactions to the vaccine. In another 2011 study, 64 egg-allergic children received the vaccine. One got hives, and two had a single hive; none of them had wheezing, shortness of breath, tight throat or more serious reactions. A higher percentage of the control group (kids without egg allergy) got hives after their flu shot.

If you are egg allergic, it is recommended you get your flu shot in a doctor's office; if you have a severe egg allergy, or had a serious reaction after getting a flu shot, it is recommended you get the flu shot in an allergist's office. Remember, there is definitely a risk to not getting immunized – influenza-related illness in the U.S. averages 200,000 hospitalizations per year and 10,000 deaths per year.

Note: Information contained in this article should not be considered a substitute for consultation with a board-certified allergist to address individual medical needs.