Tag: egg allergy

Do Vaccines Cause Food Allergies?

Why do some folks think that vaccines can cause food allergies?

It’s likely for the same reason that they think that vaccines can cause eczema and reflux.

Many infants develop the first signs of food allergies around the same time that they are getting their first vaccines…

Do Vaccines Cause Food Allergies?

To be clear, vaccines can be associated with food allergies, including:

  • eggs – most children with an egg allergy can get the flu shot, although the yellow fever vaccine could still be an issue
  • gelatin – some vaccines use gelatin, like in Jell-O, as a stabilizer
  • yeast – although they aren’t thought to be an issue for kids with yeast allergies, a few vaccines can have residual amounts of yeast in them
  • milk – very rarely and mainly based on scattered case reports, it is thought that residual casein proteins in DTaP/Tdap vaccines could trigger allergic reactions in some kids with severe milk allergies

But vaccines don’t cause these food allergies.

What about peanut allergies? Peanut oil is not actually a component of vaccines and vaccines have not caused a peanut allergy epidemic.

And FPIES?

“Food Protein Induced Enterocolitis Syndrome (FPIES) is a type of non-IgE mediated food allergy that can present with severe vomiting, diarrhea and dehydration.”

Food Protein-Induced Enterocolitis Syndrome (FPIES)

It is important to note that having FPIES is not a contraindication to getting vaccinated.

And that’s not surprising, as there is no biologically plausible mechanism for any association between FPIES and vaccines!

What about the rotavirus vaccines? Could they be causing FPIES?

FPIES was recognized in the mid-1970s. We didn’t have a rotavirus vaccine back then.

Could it have been the oral polio virus, which we were using in the 1970s?

“Some researchers have speculated that T cells play a central role in the development of the localized inflammation in the intestinal tract that characterizes FPIES, but this theory has not been confirmed.”

Food Protein-Induced Enterocolitis Syndrome

If it was, then why didn’t FPIES go away when we stopped using the oral polio vaccine in 2000. Or when we used neither OPV nor a rotavirus vaccine, from 2000 to 2007?

“The reviewed epidemiological evidence indicates that, although possibly not contributing to optimal stimulation of the immune system in infancy, current infant vaccines do not cause allergic diseases.”

Koppen et al on No epidemiological evidence for infant vaccinations to cause allergic disease.

There is also no evidence that vaccines are causing other types of food allergies.

Vaccines are safe, with few risks, and are obviously necessary.

As you wait for your child to hopefully outgrow their food allergy, don’t unnecessarily skip or delay their vaccines and leave them at risk to get a vaccine preventable disease.

Vaccines and Food Allergies

Anaphylaxis After Vaccines

Anaphylaxis after vaccines is a well known side effect, but just how common is it?

Anaphylaxis After Vaccines

Since it is listed as a possible reaction to nearly all vaccines and it can be life-threatening, anaphylaxis must be fairly common, right?

“Vaccine providers should be familiar with identifying immediate-type allergic reactions, including anaphylaxis, and be competent in treating these events at the time of vaccine administration. Providers should also have a plan in place to contact emergency medical services immediately in the event of a severe acute vaccine reaction.”

Preventing and Managing Adverse Reactions

After all, pediatricians even get warned to have a plan in place and to be prepared to treat children just in case they develop anaphylaxis after getting their vaccines.

Your pediatrician will likely have an EpiPen in the office in case your child has an anaplylactic reaction after his vaccines.
Epi Is Readily Available to Treat Most Kids with Anaphylaxis After Vaccines

Still, most probably have never had to.

“Any medication can cause a severe allergic reaction. Such reactions to a vaccine are estimated at about 1 in a million doses, and would happen within a few minutes to a few hours after the vaccination.”

Possible Side-effects from Vaccines

And that’s because anaphylaxis after vaccines is very rare.

Anaphylaxis After Vaccines is Rarely Fatal

And suprisingly, it is even more rare for these cases to be fatal!

“All 30 patients with anaphylaxis survived (9 reports specified anaphylaxis, and we classified another 21 as probable cases, based on compatible clinical features, including respiratory and skin symptoms within 4 hours after vaccination). In half of 22 detailed reports, symptoms developed within 15 minutes after vaccination.”

Wise et al on Postlicensure Safety Surveillance for Varicella Vaccine

But that study just looked at the chicken pox vaccine and used VAERS, so we have to be concerned about under-reporting, right? Well, not necessarily. Under-reporting likely isn’t a big problem for serious reactions.

Anyway, that’s not the only study…

“We identified 33 confirmed vaccine-triggered anaphylaxis cases that occurred after 25,173,965 vaccine doses. The rate of anaphylaxis was 1.31 (95% CI, 0.90-1.84) per million vaccine doses.”

McNeill et al on Risk of anaphylaxis after vaccination in children and adults

The McNeill study used the Vaccine Safety Datalink, which unlike VAERS, is not a passive reporting system. So there is no concern about underreporting.

And like the Wise study, there were no deaths among these vaccine-triggered anaphylaxis cases.

“Fatalities from vaccine-induced anaphylaxis are exceedingly rare.”

Adverse reactions to vaccines practice parameter 2012 update

Similarly, a study in the UK found rare reports of anaphylaxis after vaccines in children and all those children made a full recovery.

Parents should understand that while anaphylaxis is a known side effect to getting a vaccine, it is extremely rare, and can usually be treated. This once again reinforces that vaccines are safe!

More on Anaphylaxis After Vaccines

Three Reasons to Skip a Flu Shot This Year

We sometimes hear that folks are going to skip their yearly flu vaccine because they don’t believe in flu shots, they never get sick, or they think that flu shots don’t work or are dangerous.

Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.

Of course, none of those are good reasons.

Three Reasons to Skip a Flu Shot This Year

Flu vaccines are safe and have many benefits, even if they aren’t any where near 100% effective.

So are there any legitimate reasons to skip a flu shot?

Of course.

In fact, three very good reasons to skip a flu shot include:

  1. being younger than 6 months of age
  2. having a severe allergic reaction (e.g., anaphylaxis) after a previous dose of flu vaccine or to any component of the flu vaccine
  3. and, uh…

Actually, although folks might have many of bad excuses, there are only two good reasons to skip a flu shot…

So, infants who aren’t old enough to be vaccinated yet, and anyone who has had a life-threatening reaction to a previous dose.

Additional precautions, but not true contraindications, do including having had Guillain-Barré syndrome <6 weeks after a previous dose of influenza vaccine and having a moderate or severe acute illness with or without fever when you are planning to get vaccinated.

What about egg allergies?

Even if you have had a severe reaction to eggs, you can still get a flu shot. Just get it get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office), so that you can be supervised by a health care provider who is able to recognize and manage severe allergic reactions.

Bad Reasons to Skip a Flu Shot

Are you scared of shots? Flumist is back.

Are you skipping the flu shot because you never get sick? How lucky do you feel this year? Don’t continue to gamble that you won’t get the flu. Increase your chances of staying well by getting a flu shot, the best way to avoid the flu.

There aren’t any natural alternatives that work better, no matter how hard you want to believe that going to a chiropractor, using essential oils, or homeopathic remedies might be helpful.

The flu vaccine doesn’t weaken your immune system.

There are no hidden or harmful ingredients in flu vaccines.

The flu vaccine is not going to give you the flu.

And the flu is definitely not a mild disease! There were 176 pediatric flu deaths last flu season, and as in most years, most were unvaccinated.

Don’t wait. Get your flu shot.

More on Flu Vaccine Contraindications

Can You Really Get a Flu Shot If You Are Allergic to Eggs?

Are you still worried about your child’s egg allergy and getting them a flu vaccine?

Everyone needs a flu shot. When will you get yours?
Everyone needs a flu shot. Even kids with egg allergies. Photo by Gabriel Saldana (CC BY-SA 2.0)

That’s not surprising, as we once warned people about residual egg proteins in flu vaccines and the possibility of immediate hypersensitivity reactions in those with severe egg allergies.

Flu Vaccines and Egg Allergies

Of course, that advice has now changed, even though most flu vaccines are still prepared in chicken eggs.

“Recent studies have shown that even individuals with confirmed egg allergy can safely receive the flu vaccine. The Joint Task Force on Practice Parameters of the American Academy of Allergy Asthma and Immunology and the American College of Allergy Asthma and Immunology as well as the American Academy of Pediatrics state that no special precautions are required for the administration of influenza vaccine to egg-allergic patients no matter how severe the egg allergy.”

Egg Allergy and the Flu Vaccine

In fact, it began to change in 2011, when we got the recommendation that it was okay to give flu shots to people with egg allergies, if they only get hives as their reaction. It was still recommended that those with more severe allergic reactions to eggs “be referred to a physician with expertise in the management of allergic conditions for further risk assessment before receipt of vaccine.”

Before that, we would sometimes do skin testing on high risk egg allergic kids, desensitization, or regular chemoprophylaxis.

In 2013, the recommendation changed so that those with severe allergic reactions to eggs should get their flu shot “by a physician with experience in the recognition and management of severe allergic conditions.”

The recommendations were again modified in 2016, removing the recommendation that egg-allergic flu vaccine recipients be observed for 30 minutes and that those with severe egg allergies “should be vaccinated in an inpatient or outpatient medical setting (including but not necessarily limited to hospitals, clinics, health departments, and physician offices), under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.”

Why the changing advice?

It’s because severe allergic reactions to vaccine are rare (in a million doses rare). And even in the flu vaccines that still use eggs, almost all of the egg protein is removed from the final vaccine. So that residual amount of egg protein is unlikely to trigger an allergic reaction. And that’s what we saw as the recommendations were slowly changed year after year.

Getting a Flu Shot When You Are Allergic to Eggs

And that’s why we have our current recommendations:

  • Those with a history of egg allergy who only get hives can get any age-appropriate flu vaccine.
  • Those with a history of egg allergy who have severe reactions, including angioedema, respiratory distress, lightheadedness, recurrent emesis, or who required epinephrine or another emergency medical interventions, can still get any age-appropriate flu vaccine, but they should get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office). And the vaccine administration should be supervised by a health care provider who is able to recognize and manage severe allergic reactions.
  • Those who can eat eggs without reaction can get any age-appropriate flu vaccine.

Do you still have to be observed after getting your flu vaccine if you have an egg allergy?

No postvaccination observation period is recommended specifically for egg-allergic persons.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Nope. But that’s likely because although they are rare, reactions might not occur right away.

So yes, you can and you should get a flu vaccine if you are allergic to eggs.

More on Flu Vaccines and Egg Allergies