Patients who have egg allergies can safely receive seasonal influenza vaccines with the assistance of their allergist, according to new recommendations from the American Academy of Allergy, Asthma & Immunology.
“The time to withhold the influenza vaccine due to one’s egg allergy has passed,” Matthew Greenhawt, MD, a guideline coauthor and clinical lecturer at the University of Michigan Health System, told The Clinical Advisor.
Previously, adults and children with known egg allergies were administered a vaccine skin test to determine the likelihood of an allergic reaction.
If the test results were negative, a clinician would administer a single recommended dose for age. If the test results were positive, the clinician would use a step-wise approach, administering the first 10% of the recommended dose, followed by a 30-minute observation period before administering the remaining 90%.
“Last year’s H1N1 pandemic and need to vaccinate children with a second influenza vaccine prompted many allergy groups, including ours at the University of Michigan, to re-evaluate the evidence surrounding the safety of providing the egg-protein containing influenza vaccine to egg-allergic children,” Greenhawt said.
Data from three studies conducted last year indicated that skin testing was not predictive of vaccine outcome, and that either vaccine protocol is acceptable without preliminary skin testing.
“Neither route of administration has been shown to be superior to the other, and this provides the clinician flexibility in their approach, since either method is acceptable,” Greenhawt explained.
Limited data from two of last year’s studies suggest that individuals with severe anaphylactic egg allergies may be eligible for vaccination with similar methods. Additional studies are currently underway to evaluate safety in these individuals.
Greenhawt emphasized the importance of observing egg-allergic patients for 30 minutes after vaccination, and advises clinicians to have an allergist and resuscitative equipment on hand as precautionary measures.