May 17, 2017:
A revised version of the ASCIA Guidelines for vaccination of the egg-allergic individual is now available, which aims to provide updated recommendations for vaccination of egg-allergic individuals, consistent with international and current Australian and New Zealand Guidelines. The updated Guidelines are available open access on the ASCIA website: www.allergy.org.au/health-professionals/papers/influenza-vaccination-of-the-egg-allergic-individual
The following is a summary of the revisions.
- Based on prospective and retrospective studies of influenza vaccination in those with and without egg allergy (including egg anaphylaxis), the presence of egg allergy does not increase the risk of allergic reactions to the influenza vaccine.
- The entire vaccine can be administered in community vaccination clinics (which may or may not have direct medical practitioner supervision) as a single dose followed by the recommended 15 (Australia) or 20 (New Zealand) minute waiting period.
- In making this recommendation, we are aware that some guidelines (e.g. CDC 2017) recommend a longer waiting period of 30 minutes in those with past egg anaphylaxis and that occasionally allergic reactions to vaccination may commence later than 20-30 minutes after administration The immediate availability of medical practitioner care is recommended and staff should be familiar with the recognition and treatment of anaphylaxis.
- In individuals who have had anaphylaxis following administration of the influenza vaccine itself, further vaccination should be avoided without specialist allergy assessment.
- If there is significant parental or health professional anxiety, the vaccine may be administered in primary care settings with a longer waiting period of 30 minutes.
- “Split dosing”
- Allergy testing with the vaccine or to egg prior to administration
- Ingestion of egg as a pre-condition to administering the vaccine (relevant in infants)
- Vaccination in specific hospital-based vaccination clinics
- Allergy specialist review before influenza vaccination unless anaphylaxis to the influenza vaccine itself has occurred previously
Content updated 17 May 2017