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Egg Allergy and Vaccinations

Pediatrics Expert Advice from Henry Bernstein, M.D.

Q: We have a 1-1/2-year-old boy who seems to have an allergy to eggs. He experiences an allergic reaction and refuses to eat any eggs. He eats foods that contain eggs (cakes). The problem is that the doctor here in Israel refuses to give him the measles vaccination as it may be a danger and says that he can only be vaccinated in an ER or after eating eggs directly. What do you think of this and is it important to vaccinate him or not?

A: From the information you've provided, I would recommend that your son be vaccinated against measles. First of all, your child only "seems to have an allergy to eggs." Secondly, significant allergic reactions to the shot occur very rarely. Measles is a highly contagious disease that can cause significant problems in someone without protection.

Although the measles vaccine is produced in a chick embryo cell culture, it does not contain large amounts of egg proteins--things he could react or be allergic to. In fact, children with egg allergies are at low risk for severe allergic reactions (anaphylaxis) to the measles-containing vaccines. Persons with allergies to chicken or feathers are also not at increased risk of reaction to the vaccine. Unfortunately, allergy skin testing of children possibly allergic to eggs is not even predictive of reactions to the MMR vaccine. Thus, some experts do not even feel that there is a reason to be tested and that these children should just be vaccinated in the usual manner.

In contrast, those children who have had a past allergic (hypersensitivity) reaction to a measles vaccine can be skin tested before the second dose or their antibodies can be tested to determine if there is even a need for a second dose. Certainly, if someone has had any severe allergic reaction (anaphylaxis) to prior vaccination, they should be vaccinated only in settings where an immediate, life-threatening reaction can be managed. The bottom line is I would not want to leave him unprotected, so please continue the in depth dialogue with his doctor.

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Henry Bernstein, M.D., is currently the associate chief of the Division of General Pediatrics and director of Primary Care at Children's Hospital, Boston. He also has an academic appointment at Harvard Medical School.

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