It’s that time of year again – flu season! No-one wants to suffer through flu and this year, with Covid-19 around, it’s even more important to protect people with lowered immune systems, pregnant women or people with other medical conditions like asthma. In terms of allergy, I see a a lot of confusion about one question: Is the flu nasal spray safe for egg allergy?
Both my children have severe egg allergies and cannot tolerate baked egg, yet they have had the flu nasal spray safely for the past four years and will do so again this year.
HOW DO YOU KNOW THE FLU NASAL SPRAY IS SAFE FOR EGG ALLERGY?
The Sniffle Study looked at whether the amount of egg in the flu nasal spray (also called LAIV or Fluenz) was enough to cause a reaction. They recruited over 300 children diagnosed with an egg allergy, 115 of whom had prior anaphylaxis and 186 with a history of asthma.
They found that none of the children had a systemic or anaphylactic reaction to the nasal spray. 8 children had mild reactions and 26 had some coughing or wheezing within 3 days.
WHAT ABOUT CHILDREN WITH SEVERE EGG ALLERGIES?
A lot of the literature says children with severe egg allergies should avoid the nasal spray but doesn’t clarify what this means. The guidance based on the study is that, for precaution, any child that has been in intensive care due to an anaphylactic reaction to egg should talk to their allergist about having it at hospital.
CAN EGG ALLERGIC CHILDREN HAVE THE FLU NASAL SPRAY AT SCHOOL?
Yes, it is possible for children with egg allergies to have the nasal spray at school, nursery or at the GP. If you are concerned, talk to your doctor about having it in a clinical setting
IS THERE AND EGG FREE FLU INJECTION FOR 2020?
There is an egg free flu injection available for 2020 called the Quadrivalent influenza cell-culture vaccine (QIVc). This is available for adults and children over 9 years old.
IS ASTHMA A RISK FACTOR?
Children with asthma are safe to have the flu nasal spray or injection. They should not have it if they are currently taking oral steroids, have been prescribed them in the last 14 days or have had active wheezing or increased use of their inhalers in the last 72 hours.
IS THERE ANY RISK OF ANAPHYLAXIS?
People can be allergic to other components of the flu vaccine which can cause anaphylaxis, although this is rare.
If you have any concerns, or for more personalised advice, talk to your GP or allergist.
Here are some links to the scientific studies and current guidance.
Anaphylaxis Campaign: Nasal spray safe for children with egg allergies
NHS England Influenza vaccines for 2020-2021
Influenza: the green book, Public Health England (page 19)
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