question and answer
January 1995
DOBRILA VUJNOVIC, MD, of Toronto, Ont. writes in with this problem: "How would you deal with a one-year-old baby who needs an MMR vaccination but is allergic to eggs (breaks out in hives 15 to 20 minutes after ingestion) and has atopic dermatitis?"
The vaccines that currently contain trace amounts of egg antigens are measles vaccine, mumps vaccine, inacctivated influenza virus vaccines and yellow fever vaccine. Only those individuals with anaphylactic symptoms after egg ingestion should have vaccination withheld or, if necessary, desensitization undertaken. For the baby described above it would be resonable to arrange a referral to an allergist- immunologist. Skin testing with very small amounts of vaccine can be performed to confirm the risk of a serious reaction. It should be noted however that after 160 million doses of measles vaccine have been administered in the U.S., only a handful of serious allergic reactions have been reported. DM
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