Hot Topics: Egg Allergies
By: Jonathan Spergel, MD, PhD.
Dr. Spergel is Chief of the Allergy Section and Co-Director of the Center for Pediatric Eosinophilic Disorders at The Children’s Hospital of Philadelphia
Egg allergy
Egg allergy is one of the more common pediatric food allergies. It typically affects just 0.5 percent of the pediatric population (less than 1 of every 100 children) and 5 of every 100 children with allergies. Reactions to egg can vary from life-threatening anaphylaxis to atopic dermatitis (eczema) to hives.
Food allergies are diagnosed by physical examination, previous experience, and allergy testing. There are two types of allergy testing: skin testing and blood testing for specific antibodies to eggs (commonly called RAST testing). Each test has advantages and disadvantages. In general, if you are negative on either test, you do not have an allergy to egg; however, the blood test can be negative in about 5 of every 100 children who actually have an egg allergy. A positive blood or skin test indicates a potential to react to egg, and the larger the skin or blood test, the more likely it is that a reaction will occur. However, the size of the skin or blood test does not correlate with how severe a reaction will be.
Egg allergies and vaccines
Because influenza and yellow fever vaccines are both made in eggs, egg proteins (primarily ovalbumin) are present in the final products and are in sufficient quantities to cause allergic reactions in susceptible patients.
In the case of the yellow fever vaccine, quantities are sufficient to cause allergic reactions in susceptible patients. If you or your child is allergic to eggs and you are interested in getting the yellow fever vaccine, you should make an appointment with an allergist.
Advances in technology have allowed the quantities in current influenza vaccines given as shots to be so minimal that people with egg allergies can now receive the influenza shot. However, because very low quantities of egg protein are still present, people with this allergy should remain in the provider’s office for about 30 minutes after receiving the vaccine.
What about future doses of the vaccine?
Current protocols require that people with egg allergies repeat the process with an allergist each time they get the vaccine because the protocols do not prevent the allergy, they simply provide a way to get around the allergic response in the short term, so that the vaccine can be given safely.
References
Erlewyn-Lajeunesse et al, BMJ 2009
Piquer- GIbert M, Allergol Immunopathol (Madr). 2007 Sep-Oct;35(5):209-12
James et al, J Pediatr. 1998 Nov;133(5):624-8
Saltzman, et al. J Aller Clinical Immuno 2009; 123 (2):S175
Reviewed by: Paul A. Offit, MD
Date: October 2011
Materials in this section are updated as new information and vaccines become available. The Vaccine Education Center staff regularly reviews materials for accuracy.
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