Flu Vaccine Recommendations and Food Allergy

The FDA has approved flu vaccine for 2010-2011 in the United States. Vaccine is expected to be available beginning in September 2010. This year's vaccine will protect against 3 strains of influenza, including H1N1, which last year required a separate shot. The brand names and manufacturers are:

• Afluria, CSL Limited;
• Agriflu, Novartis Vaccines and Diagnostics
• Fluarix, GlaxoSmithKline Biologicals
• FluLaval, ID Biomedical Corporation
• FluMist, MedImmune Vaccines Inc.
• Fluvirin, Novartis Vaccines and Diagnostics Limited
• Fluzone and Fluzone High-Dose, Sanofi Pasteur Inc.

As flu vaccine is cultured in egg, there are risks for those with egg allergies. I list the names and manufacturers here because the composition of the vaccine varies according to manufacturer. It may be helpful to contact your doctor's office to find out which brand they will use allowing you to check the manufacturer website and read the package inserts.

As stated in the recently released "Recommendations of the Advisory Committee on Immunization Practices", "

hypersensitivity reactions after receipt of vaccine are caused by the presence of residual egg protein in the vaccine). Although influenza vaccines contain only a limited quantity of egg protein, this protein can induce immediate hypersensitivity reactions among persons who have severe egg allergy. Persons who have documented IgE-mediated hypersensitivity to eggs might be at increased risk for allergic reactions to influenza vaccine, and consultation with a physician before vaccination should be considered.

A regimen, involving desensitization, has been developed for administering influenza vaccine to those with egg hypersensitivity.

This is a tough call for parents of egg allergic children and adults with egg allergy. There has been a lot of chatter on the topic on this blog and others.

Last year, our family got the vaccine, except for my egg allergic son. Instead, we chose to request a prescription for an antiviral drug (like Tamiflu®) to have on-hand in the event of the sudden appearance of flu symptoms. Another option is prophylactic use of antiviral agents, where antiviral drugs are taken over a period of time to protect against the flu.

This year...I don't know what we're doing. Recent reports indicate low risk of reactions when the flu vaccine was administered to those with egg allergy.

...uh huh, but this is my child....

Where are all of you with this decision?

Egg-free vaccines are available, but not yet approved in the U.S. Soon we may not have to make these tough choices.

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Guidelines for H1N1 Vaccine and Egg Allergy

The American Academy of Allergy Asthma and Immunology has come out with their guidelines regarding H1N1 vaccine and those with egg allergy.

I'm really torn about how to proceed with this. My son recently underwent an egg challenge in the allergist's office. It was not successful. Looking over the AAAAI guidelines, it appears that he would need several skin pricks (which he hates) and then if we proceed, he may require 5 vaccines at 15 minute intervals. If a medical issue arises, we face a shot of epinephrine and perhaps inhaled steroids. Ugh!

And that's just the H1N1 vaccine. This whole procedure is repeated for the seasonal flu vaccine. For the past few years, the rest of the family has received the seasonal flu vaccine. I get mine this afternoon. Our egg allergic son has not gotten the vaccine. Swine flu makes me more nervous.

What are the rest of you with egg allergies or egg allergic children doing? I know that I need to contact our allergist, but I'm not sure we want to go down the road that will be recommended...

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