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.


Libby said...

My son is far less allergic to egg yolk than whites, so we did an oral challenge to yolk only. He was able to tolerate a very small quantity of yolk, so he received the flu vaccine in two doses under observation at the doctor's office.

I didn't want to depend on herd immunity because he has asthma. We'll most likely do the same again this year.

Kate said...
This comment has been removed by the author.
Kate said...

My daughter failed her egg challenge at the doctor's office in January, but the reaction was small enough and slow enough that they let us introduce baked egg into her diet at home (which has gone successfully). They also advised that she could handle having a flu shot, so she got an H1N1 shot in February. There was no apparent reaction to it.

So, it's a personal call that I think is based on your child's past history. If your son is known to have major reactions to small quantities of egg, I'd skip the shot. But for our daughter, she was know to have minor reactions to very significant amounts of egg (during the egg challenge), so I felt very comfortable giving her the shot.

Sorry for long answer!