What’s the reason for the flu season?
Ask Dr. Keith Roach M.D
DR. ROACH WRITES: Many people, including a pharmaceutical company, have written to question my advice to give any flu vaccine, even those made with eggs, to a person with a history of egg allergy. The prescribing information for FluMist, for example, notes that those with a severe reaction, such as anaphylaxis, should not receive FluMist. However, the Advisory Committee on Immunization Practices and the Centers for Disease Control and Prevention state: “People with a history of egg allergy of any severity should receive any licensed, recommended, and age-appropriate influenza vaccine.” They caution that people with a history of severe allergic reaction to egg — that is, any symptom other than hives, and including anaphylaxis — undergo vaccination by a medical provider who is able to recognize and manage severe allergic conditions. Taken together, several studies have shown that, in over 4,000 individuals with egg allergy, including more than 500 people with a history of anaphylaxis, the flu shot was given with zero acute systemic allergic reactions. Because of this demonstrated safety of regular flu shots, I feel that making people search for the egg-free options (FluBlok and Flucelvax) is unnecessary and may cause some people to forgo vaccination. Interestingly, last year the egg-free vaccines appeared to have about 20% better efficacy than vaccines made with eggs. My own hospital is distributing an egg-free vaccine this year, so that’s what I got for my vaccine — my 33rd consecutive annual flu shot. The CDC also notes that “previous severe allergic reaction to flu vaccine, regardless of the component suspected of being responsible for the reaction, is a contraindication to future receipt of the vaccine.” Finally, I want to re-emphasize that FluMist is indicated only for those ages 2-49. *** Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGood-Health@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.
