Administering Flu Vaccines to Individuals with Egg Allergy

Assessment and Vaccination Protocol

Any person with egg allergy can safely receive influenza vaccination regardless of the severity of their egg allergy, with appropriate precautions based on their specific reaction history 1
The Centers for Disease Control and Prevention recommends that individuals with egg allergy first determine if they can eat lightly cooked egg without reaction - if yes, they can receive any age-appropriate influenza vaccine per usual protocol 2, 3
For those with confirmed egg allergy, assess the severity based on previous reactions, including mild reactions (hives only) 5 and severe reactions (angioedema, respiratory distress, lightheadedness, recurrent emesis, or reactions requiring epinephrine or emergency medical intervention) 2, 4, 5

Administer any age-appropriate influenza vaccine (IIV or cell culture-based) to patients with mild egg allergy (hives only), and observe the patient for at least 30 minutes after vaccination 1, 2, 4
Ensure vaccination is administered by a healthcare provider familiar with potential manifestations of egg allergy 3
For adults 18-49 years with severe egg allergy, consider recombinant influenza vaccine (RIV), which is egg-free 2, 4

All vaccines should be administered in settings where personnel and equipment for rapid recognition and treatment of anaphylaxis are available 1, 6
All vaccination providers should be familiar with their office emergency plan and be certified in cardiopulmonary resuscitation 1, 6
The American College of Allergy, Asthma, and Immunology recommends that special measures such as dividing the dose or skin testing with the vaccine are no longer considered necessary 4

For pregnant women with egg allergy, the same protocols apply, as the benefits of vaccination outweigh the risks 1
For immunocompromised patients with egg allergy, influenza vaccination is particularly important and can be administered following the same protocols 1