Thank you for your recent inquiry.
The CDC has released very explicit recommendations for the administration of influenza vaccine in general, and for the administration of this vaccine to people with egg allergy, with special reference to patients with anaphylaxis related to the ingestion of egg. For your convenience, a link to the entire website is copied for you below. I think it is important for you to read the entire document. I have copied below the most salient part of this document referable to your inquiry. However, there are nuances which are important for you to note in other sections of the document.
In summary, if the reaction to egg was anaphylactic in nature, then a skin test is recommended by the CDC.
Thank you again for your inquiry and we hope this response is helpful to you.
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6033a3.htm?s_cid=mm6033a3_w View this website for noted figures below.
Recomme ndations Regarding Persons with Egg Allergy
Each of the following recommendations applies when considering influenza vaccination of persons who have or report a history of egg allergy.
1. Persons who have experienced only hives following exposure to egg should receive influenza vaccine with the following additional measures (Figure 2):
a) Because studies published to date involved use of TIV, TIV rather than LAIV should be used.
b) Vaccine should be administered by a health-care provider who is familiar with the potential manifestations of egg allergy.
c) Vaccine recipients should be observed for at least 30 minutes for signs of a reaction following administration of each vaccine dose.
Other measures, such as dividing and administering the vaccine by a two-step approach and skin testing with vaccine, are not necessary.
2. Persons who report having had reactions to egg involving angioedema, respiratory distress, lightheadedness, or recurrent emesis, or persons who required epinephrine or other emergency medical intervention, particularly those that occurred immediately or within minutes to hours after egg exposure are more likely to have a serious systemic or anaphylactic reaction upon reexposure to egg proteins. Before receipt of vaccine, such persons should be referred to a physician with expertise in the management of allergic conditions for further risk assessment (Figure 2).
3. All vaccines should be administered in settings in which personnel and equipment for rapid recognition and treatment of anaphylaxis are available. ACIP recommends that all vaccination providers be familiar with the office emergency plan (18).
4. Some persons who report allergy to egg might not be egg allergic. Those who are able to eat lightly cooked egg (e.g., scrambled eggs) without reaction are unlikely to be allergic. Conversely, egg-allergic persons might tolerate egg in baked products (e.g., bread or cake); tolerance to egg-containing foods does not exclude the possibility of egg allergy (35). Egg allergy can be confirmed by a consistent medical history of adverse reactions to eggs and egg-containing foods, plus skin and/or blood testing for immunoglobulin E antibodies to egg proteins.
5. A previous severe allergic reaction to influenza vaccine, regardless of the component suspected to be responsible for the reaction, is a contraindication to receipt of influenza vaccine.
Sincerely,
Phil Lieberman, M.D.