The NIAID clinical guidelines for food allergies do not recommend influenza vaccines to patients with a history of severe allergic reactions to eggs or chicken. If you have mild reactions to eggs, chicken, or feathers, however, you should be able to tolerate the flu vaccine.
“Severe allergic reactions” include:
The Advisory Committee on Immunization Practices (AICP), the American Academy of Pediatrics (AAP), and the manufacturers of flu vaccines all advise people with a history of severe allergic reactions to eggs to avoid getting the flu vaccine.
However, there have been several small clinical trials in which people with severe egg allergies have been given the flu vaccine in multiple doses and have been able to tolerate it without systemic reactions.
In several studies, doctors first gave participants a skin prick test to the vaccine itself. If the test was negative, indicating that the participant was not allergic to the vaccine, then the vaccine was given. Some doctors split the vaccine into multiple doses and monitored the response to each dose before giving the next.
Some flu vaccines contain less egg protein than others. Most of these studies used a low-ovalbumin vaccine.
Because of the lack of consensus over the safety of the flu vaccine, the NIAID clinical guidelines state that there is not enough evidence of the safety of flu vaccines to recommend them to people with severe egg allergies.
You and your doctor should weigh the risks and potential benefits of the flu vaccine. For a child with severe asthma and a mild egg allergy, the potential benefits of avoiding the flu probably outweigh the small risk involved in getting a flu shot in a doctor’s office. For a child with a history of more severe reactions, the decision is more complicated.
Chung EY, Huang L, Schneider L Safety of influenza vaccine administration in egg-allergic patients. Pediatrics 2010 May;125(5):e1024-30.213.
Zeiger RS. Current issues with influenza vaccination in egg allergy. J Allergy Clin Immunol 2002 Dec;110(6):834-40.
Kelso JM. Administration of influenza vaccines to patients with egg allergy. J Allergy Clin Immunol 2010 Apr;125(4):800-2.
NIAID-Sponsored Expert Panel. Guidelines for the Diagnosis and Management of Food Allergy in the United States: Report of the NIAID-Sponsored Expert Panel. The Journal of Allergy and Clinical Immunology. Volume 126, Issue 6, December 2010