In a recent statement from the American Academy of Allergy, Asthma and Immunology (AAAAI), the AAP is updating its guidance for administering influenza vaccine to children with presumed egg allergies. These recommendations are not appropriate for the egg allergic person with a history of anaphylaxis or severe allergy.
Skin testing is no longer necessary, Use the lowest ovalbumin-containing influenza vaccine, Utilize one of the following 2 methods for administration 1) 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 2) Single age-appropriate dose followed by 30 minutes of observation 3) Appropriate resuscitative equipment always must be available in the office when employing either of the previous mentioned methods.
More details can be found in a December 2010 AAP New article. Additional information can also be found in the “Guidelines for the Diagnosis and Management of Food Allergy in the United States” published in December 2010 by the National Institute of Allergy and Infectious Diseases.