Egg allergy is one of the most common food allergies, especially among children. About 2 percent of children have an egg allergy, but about 70 percent of children outgrow this allergy before the age of 16.
Egg allergy symptoms can range from minor complications, such as hives, to life-threatening complications, such as anaphylaxis.
Keep reading to learn more about egg allergies and flu shots, and your alternative options.
What’s the Connection Between Egg Allergy and Flu Shots?
Traditional flu shots contain a small amount of egg protein. If you or your child has an egg allergy, you may worry about whether it’s safe for them to get a flu shot. But take heed. The risk to those who have egg allergies is extremely small, and there are egg-free alternatives available today.
Most viral strains used to create influenza vaccines come predominately from birds, says Randy Bergen, MD, pediatrician and infectious disease specialist at Kaiser Permanente Walnut Creek Medical Center. He’s also the clinical lead for the Kaiser Permanente flu vaccine program in Northern California.
Bergen explains that eggs are used to incubate the viral strains during the manufacturing process. Although the virus is taken out of eggs prior to finalizing the vaccine, a small amount of protein can remain.
The amount of this protein gets smaller every year. Bergen says researchers are refining the process so that even traditional flu vaccines only contain a trace amount of egg protein.
What Are the Risks?
The risk depends on the severity of your egg allergy. The risk of having any reaction to even traditional flu shots is minimal for the vast majority of people. Most people who have any reaction will only experience minor symptoms.
If you have a severe egg allergy, you should think twice before getting a flu vaccine. This is especially true if you experience any of the following after egg exposure:
- breathing problems, such as wheezing
Your risk of having a serious adverse reaction to the egg protein in a flu vaccine is very low even if you have a severe egg allergy. A review published in the Journal of Allergy and Clinical Immunology looked at over 4,000 people with egg allergies who were given the flu vaccine. They didn’t find evidence of a serious reaction from the flu shot among any of these individuals.
Even the nasal mist flu vaccine shows a low risk of reaction. In another recent study, 282 children with egg allergies were given the live attenuated nasal spray flu vaccine. None experienced anaphylaxis, and only about 25 percent of the children experienced some form of mild allergy symptoms. These included nasal congestion, mild wheezing, and eczema flare. The rest had no reaction at all.
Eve Gordon, MD, chief of service for the allergy department at Kaiser Permanente Panorama City Medical Center, has seen similar results where she practices.
“We have been giving flu vaccines to egg-allergic patients in our clinic for the past two years without splitting the dose or doing any preliminary skin testing,” she says. “We just observe the patients for 30 minutes after the shots.”
According to Gordon, she has seen only one case of hives and one case of diarrhea the day after. No serious reactions have occurred.
The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices currently advises that most people with an egg allergy can now receive the trivalent flu vaccine. It’s recommended that you wait at the doctor’s office or immunization clinic for 30 minutes after receiving the vaccine. This way, your doctor or physician will be able to tell if you’re showing any symptoms and treat them accordingly.
What Does an Allergic Reaction Look Like?
The vast majority of egg-allergic people who have any reaction to the flu vaccine show minor side effects. These could include:
- a stuffy nose
- an itchy rash
- a tingling sensation in your mouth
These symptoms can usually be treated with a mild antihistamine, but you should call your doctor if you’re concerned.
A more serious reaction that includes wheezing, problems breathing, or swelling of your mouth should prompt immediate attention. This could be a sign of anaphylaxis. You’ll want to consider using your injectable epinephrine (EpiPen) and call for medical help.
Are There Any Available Egg-Free Alternatives?
It’s important to note that not all flu vaccines contain egg protein. For example, Bergen points to two new vaccines that are made with cell culture technology and contain no egg protein:
- Flublok is made from an insect virus and is manufactured without any egg exposure.
- Flucelvax uses the same cell-based technology, but it may contain a very minute amount of the seed virus.
The Food and Drug Administration approved both of these vaccines in 2013. Bergen recommends Flublok for people with severe egg allergies. For people who have a mild or moderate egg allergy, Flucelvax can be a safe alternative. If getting Flucelvax, your doctor may want to observe you for 30 minutes after getting the shot.
Overall, Gordon says the flu vaccine is the best way to prevent influenza, which can be a dangerous and sometimes life-threatening illness. If doctors follow the simple recommendations above, she says the benefit of getting the flu vaccine far outweighs the risks of an allergic reaction for most people with an egg allergy. If you’re worried about traditional vaccines, ask your doctor about safer or egg-free alternatives.