People with egg allergy can have H1N1 flu vaccine in graded doses

As flu season got underway this fall, Dr. Catherine Monteleone, an allergist, noticed that her office started to receive an unusually high number of calls from people with egg allergy. They previously had avoided flu vaccines because of their sensitivity to eggs. This year, with all the attention being paid to the novel H1N1 influenza, those patients want to be protected against flu, and they contacted her to find out if they are candidates for inoculation.

"Seasonal and H1N1 flu vaccines are produced in chicken embryos - eggs - so people who have egg allergy generally avoid them," Monteleone, an associate professor of medicine at the UMDNJ-Robert Wood Johnson Medical School, explained. "But there are ways to get vaccinated."

Patients first should consult with an allergist about the risks and benefits of vaccination, she recommends. Those with a known history of egg allergy or those who suspect an egg allergy must then undergo a skin test for egg allergy and for the vaccine. "Some people think they have an egg allergy because they experience abdominal upset from eating eggs, but that may not be a true allergy," she said. "That may be intolerance."

If the skin tests are negative, patients may proceed to receive the full dose of the vaccine, Monteleone said.

Even if their skin tests are positive, Monteleone said people can still be vaccinated. "It may still be possible to administer the vaccine in graded doses," she explained. "During the office visit, increasing doses are given every 15 minutes, for a total of five doses."

Following completion of that process, patients will be supervised for a minimum of 30 minutes, Monteleone said. "The protocol is set forth by the American Academy of Allergy, Asthma & Immunology," she said. "This has to be done in a very careful and controlled environment."