Q: 72 year old male is improving in ICU after community-acquired pneumonia requiring ventilatory support. Flu vaccination is suggested by an automated pop up on Electronic Medical Record (EMR). Patient has a history of anaphylaxis to egg. Should Flu vaccine be administered?
A) Yes
B) No
Answer: Yes
Though it is true that most inactivated influenza vaccines (IIVs), as well as live-attenuated influenza vaccines (LAIVs), contain a small amount of egg protein but over the years in all new vaccines the amount of egg protein has decreased so significantly that even patients with a history of anaphylaxis to egg can safely receive flu vaccination. Skin testing or standard questionnaire for egg allergy is no longer required to administer flu vaccine.
To note: allergy to egg should not be equivalated to the previous reaction to the flu vaccine. Such patients should be consulted beforehand by an allergy specialist as it may be due to another component of a vaccine.
Reference:
Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2017-18 Influenza Season. MMWR Recomm Rep 2017; 66:1.
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