Egg Allergy and Influenza Vaccination

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It’s that time of year again. The weather is cooling, football season is a month old, and the leaves are starting to turn. It can only mean one thing.

You need your flu shot.

I’m sure that’s the first thing on your mind on a lovely fall day, right? Well, don’t procrastinate too long – influenza can be nasty and the influenza vaccine is your best defense. It’s not perfect and it’s better some years than others, but it is much better than nothing at all.

The technical name for the flu shot is Inactivated Influenza Vaccine, abbreviated IIV. All IIVs will contain at least 3 strains of influenza, IIV3, and some contain 4 strains, IIV4. Strains are chosen based on their prevalence in other parts of the world where flu season occurs earlier in the year. To make the vaccine, the influenza virus is grown on chicken eggs and then killed or inactivated. This means two things. First, IIV cannot give you influenza. Second, people with egg allergy have had concerns about receiving IIV.

There are plenty of data looking at the risk of receiving IIV in egg-allergic patients, and they all point to the same conclusion: IIV is safe to give to egg-allergic patients, even those with severe egg allergy. The 2012 recommendations advised patients with severe egg allergy to receive the IIV in an allergist’s office and to be observed afterwards for a period of time. We are more than happy to provide this service. However, new guidelines advise that IIV may be administered to egg-allergic patients, including those with severe egg allergy, in any appropriate clinical setting. Furthermore, they state that language describing egg-allergic patients as being at increased risk or requiring special precautions should be removed from product labeling.

These are sound recommendations and I hope they clear up what has been a source of confusion for clinicians for some time.

Dr. O

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