A recent statement put out by the American Academy of Allergy, Asthma and Immunology (AAAAI), the AAP is updating its guidance for administering influenza vaccine to children with presumed egg allergy. These recommendations ARE NOT appropriate for the egg allergic person with a history of anaphylaxis or server allergy.
1) Skin testing is no longer necessary
2) Use the lowest ovalbumin-containing influenza vaccine (Ovalbumin content is listed on the vaccine package inserts)
3) Utilize one of the following 2 methods for administration
a) Two-step graded challenge-administer 1/10th of the vaccine dose followed by 30 minutes of observation; if no symptoms emerge, administer the remainder of the dose followed by another 30 minutes of observation
b) Single age-appropriate dose followed by 30 minutes of observation
Appropriate resuscitative equipment must be available when employing either of the previous mentioned methods.
More details can be foun in the AAP News article December 2010. Additional information is in the “Guidelines for the Diagnosis and Management of Food Allergy in the United States” published in Dec by the National Institute of Allergy and Infectious Diseases.