Vaccination for child with egg allergy

Egg allergy is caused by the egg proteins in egg white. Those with allergy to egg protein get this reaction when they consume food with egg protein or get vaccine containing egg proteins.

What are symptoms of egg protein allergy?

The symptoms of allergy may include mild to very severe life threatening manifestations. We have explained in earlier posts the symptoms of the food allergy and we will summarize those here for you.

Skin manifestationsItching, measles like rash and redness and urticaria
Upper respiratory tractSneezing, running nose, selling of larynx obstructing the airway

Lower respiratory tract
Wheezing sound, difficulty in breathing, cough, intercostal retractions and respiratory failure

Heart symptoms
Increased heart rate, decreased heart rate with low blood pressure with cold limbs, fainting and loss of consciousness. It is sign of failed blood circulation and leads to death within minutes if not treated.
Perioral symptomsSpitting, Itching sensations and swelling of palate and tongue.
Digestive tractVomiting, loose motions and abdominal cramps
Symptoms of egg protein allergy

What are the features of this egg protein allergy?

When the egg protein is consumed orally these above stated symptoms and signs may come within a few minutes to few hours. It is one of. the types of the food allergy.

Usually those allergic to egg proteins are detected by symptoms occurring after consuming eggs. Usually within the first year of life.

Those allergic eggs may tolerate eggs when they are cooked or baked.

Children usually outgrow this condition if they are allergic to the egg proteins.

The children may show symptoms when they are injected with the vaccine containing egg proteins. The symptoms mild to severe like anaphylaxis may appear within minutes of injection. 

It is needed to be managed aggressively with anti allergic medicines and adrenalin or it may be life threatening.

Those with allergy to egg protein may also get this reaction in future if the infection is repeated.

Which vaccines contain egg proteins?

Well though the vaccination has the changed word for the better it may cause side effects though rare.

The life threatening side effects are rare and may be in tune of 1 in one million injections. The possibility is small but still the possibility is real.

Following vaccines contain egg proteins:

MMR/MMRV vaccine 

These vaccines are used against diseases measles, mumps and rubella and chickenpox. These are all live attenuated virus vaccines.

Influenza vaccine

Influenza vaccines are either of the live or inactivated variety. Some of them may contain proteins from eggs. Read the content of vaccines on leaflet before using the vaccine.

Rabies vaccine

Rabies is a life threatening disease caused by animal bite. Currently there is no medication for rabies disease and death is certain if someone gets rabies.

Rabies vaccine is for prophylaxis before or after bite to get protection from the rabies disease.

Yellow fever vaccine 

This is a live attenuated vaccine given to prevent yellow fever disease. It is given if you are staying in an endemic area or you are going to visit the endemic area before travel. You get a certificate of vaccination as indicated by WHO it is valid for lifetime across the entire world.

This vaccine may contain egg proteins.

Why do they add egg proteins to a vaccine?

No, they ado not add egg proteins to the vaccine. The above all vaccines are for prevention of viral diseases. Viruses are difficult to grow in the lab.

Viruses can grow only in live cells. So these viruses needed for the vaccines grow on cell culture. These cell cultures contain live cells which get infection with these viruses.

These are separated and purified and provided as vaccines. 

In simple words theoretically it seems a very easy explanation but purification is the most difficult process. 

You try to do it best but the final product contains very and very very small amounts of residues from these egg cell proteins.

This extremely small amount of egg protein is sufficient to induce allergy in some patients though very rarely, it can be life threatening.

They don’t add egg proteins intentionally into the vaccines but they are the  remainders of the vaccine production process.

Can we vaccinate a child with egg allergy?

As we stated above only types of vaccines may contain protein from eggs. All vaccines do not contain the egg proteins.

You can definitely vaccinate the child with other vaccines unless he/she is allergic to other vaccines also.

Then you may ask if the above vaccines which contain egg proteins are also important, so what to do for them.

Here is our answer: (as recommended by ACVIP and FDA)

MMR/MMRV vaccine

You can give MMR or MMRV vaccine as recommended by ACVIP to children with egg protein allergy. Give this vaccine with caution and observe the child at least for 30 minutes after vaccination.

Rabies vaccine

As discussed earlier Rabies is a deadly disease and we can not hold rabies vaccination for any cause. It should be given with caution. 

Use desensitization therapy if needed for this vaccination as those may help to reduce the reaction.

Influenza vaccine

Give the influenza vaccine with caution or choose to give the brand of influenza vaccine that does not contain egg proteins. 

You can seek the help of an allergy specialist if the child has got a severe reaction at the time of the previous doses.

Yellow fever vaccine

Avoid yellow fever vaccine in patients and children with egg protein allergy. If absolutely necessary you can take help of an allergy specialist.

What cautions to take if a child has egg protein allergy?

We will state some facts about vaccination in children with egg protein allergy. These facts stand true for all other vaccinations as general precaution followed and it helps to fight any type of allergic reaction. Following is the list of cautions:

  • Always get the vaccine from the center where the facility to manage adverse reactions and anaphylaxis is available.
  • Pediatricians can manage the anaphylaxis reaction if all the medicines and equipment needed are available.
  • Stay under observation at least 30 minutes after the vaccination.
  • Ideally the emergency kit to manage anaphylaxis should be ready before you take any type of injection be it a vaccine or some other medicines.
  • If there is a past history of severe life threatening allergic reaction like anaphylaxis also consider taking the opinion of an allergy specialist if available.

What about food if a child has egg allergy?

Those children who have egg protein allergy may suffer when the food contains egg protein allergy.

Eggs are added in many dishes and usually it is difficult to avoid them completely. This stands true if you are staying in a country with eating habits similar to western standards.

Surprisingly eggs when cooked or baked adequately usually children allergic to egg protein tolerate it. They don’t have any symptoms.

Encourage the diet with well cooked or baked egg proteins in children with egg allergy. This practice helps early resolution of the egg protein allergy.

Assess these children by allergy specialists periodically to see whether allergy has resolved.

What is the prognosis of egg allergy?

Though children may suffer early years of life because of egg protein allergy and as parents you may be worried, but there is good news.

There is a good 90 percent probability that this egg allergy will resolve in coming years and mostly till 7 years of life. It never reappears for the entire life if resolved.

Unfortunately few may suffer further with egg allergy for the entire life. An allergy specialist may help you to deal with it.

Should you avoid eggs during pregnancy or nursing the baby?

Many pregnant mothers are under the misconception that avoiding eggs may prevent egg allergy in children. It is the myth and not the fact.

Unless your doctor specifically tells you for some other reason you should eat eggs during pregnancy and breastfeeding. Eggs are a good source of rich proteins and vitamins that will help you and your baby.

Just note please do not introduce eggs to infant food before 6 months of age. Follow exclusive breastfeeding till 4-6 months of age.

When your doctor advises complementary feeding start with low risk foods and after that introduce high risk food like cow milk and eggs.

This practice may prevent development of egg allergy.

<span class="has-inline-color has-luminous-vivid-orange-color">Dr Yatin Bhole MBBS DCh DNB</span>
Dr Yatin Bhole MBBS DCh DNB

This article was written by Dr Yatin Bhole who is practicing Pediatrician at Bhole Children Clinic, Ravet. This post is for general information and before applying it on yourself, you should meet your doctor or meet us in person.

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