Summary of joint consensus statement 2018 on vaccination in egg-allergic patients

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Allergy / Immunology Other Public Health Allergies & Immunity Nutrition & Disease Management
Summary of joint consensus statement 2018 on vaccination in egg-allergic patients
  • Vaccines like influenza, measles-mumps-rubella (MMR), measles-mumps-rubella-varicella vaccines (MMR-V) are developed in chicken egg embryos or chicken cell fibroblasts
  • Administration of these vaccines in egg-allergic patients has been a historical topic since the egg proteins in these vaccines may trigger an immediate allergic reaction
  • International guidelines published lately have recommended that these vaccines are safe even when administered to egg-allergic patients
  • The Hong Kong Institute of Allergy and the Hong Kong society for Paediatric Immunology Allergy & Infectious Diseases have:
    • Summarized latest updates
    • Provided recommendations for general practitioners and paediatricans in Hong Kong
       
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Summary of key recommendations

  • As a matter of routine in primary care:
    • ALL patient with suspected or confirmed egg allergy should receive the MMR/MMR-V vaccination
  • Influenza vaccines :
    • Are recommended and safe for disease prevention in patients allergic to egg
    • Are recommended to be administered in an out-patient or ambulatory setting
  • Referral to an allergist for further evaluation prior to influenza vaccination is needed:
    • ONLY for patients who have required admission to an intensive care unit for severe anaphylaxis previously
  • If patients have significant concern:
    • Parents or healthcare professionals who can recognize signs and symptoms of an allergic reaction can offer 15 to 30 minutes of monitoring after vaccination
  • Specialist evaluation is suggested before administration of yellow fever vaccination in patients allergic to egg
  • For patients who have developed or are suspected to have developed an allergic reaction to the vaccine or vaccine components like gelatin or neomycin:
    • Further vaccination with these products should NOT be done
    • Further evaluation by an allergy specialist can be considered
  • A vast amount of suspected egg-allergic patients may be misdiagnosed:
    • Further evaluation by an allergy specialist can be considered

Reference

Chua GT, Li PH, Ho MH, Lai E, Ngai V, Yau FY, Kwan MY, Leung TF, Lee TH. Hong Kong Institute of Allergy and Hong Kong Society for Paediatric Immunology Allergy & Infectious Diseases joint consensus statement 2018 on vaccination in egg-allergic patients. Hong Kong Med J. 2018;24(5):527-531.
Link to the full article: http://www.hkmj.org/abstracts/v24n5/527.htm