[MCOH-EH] Flu immunizations for HCWs with "egg allergies"

[Robert Filler]

I have used flublok as an alternate vaccine for individuals with
reactions to prior flu vaccines independent of allergy with good
results. The studies seem to indicate egg allergy is not the issue, it
could be another sensitivity too. It could be an underlying
formaldehyde sensitivity based on fluzone and flublok being the
vaccines we use on-site. Our clinic usually gets vague reports on
prior allergy and not clear anaphylaxis, often I can reference other
vaccines received from their immunity records to try to identify a
suspected allergen but confirmation seems to never happen with
objective testing for a multitude of reasons. I suspect many of the
allergy rashes are injection site redness rather than true
hypersensitivity reactions but changing to a vaccine with a largely
separate ingredient list has served me well.

https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/b/excipient-table-2.pdf

Anecdotally, we have seen maybe a few more injection site redness
reactions than in years past. I don't know if others are seeing any
trend.

Thanks,
Rob

Rob Filler, MD, MBA, MPH
robert.filler at gmail.com

On Tue, Oct 17, 2023 at 2:05 PM Galaid, Edward <Edward.Galaid at rsfh.com> wrote:
>
> How are you dealing with HCWs who have a longstanding “history of severe egg allergy”, and ACIP’s recommendation that anybody >6 mo, regardless of severity of previous allergic reactions to egg, get any of the licensed vaccine that is otherwise appropriate for the recipient’s age and health status?  See:  https://www.cdc.gov/vaccines/acip/recs/grade/influenza-egg-allergy.html
>
>
>
> Thanks
>
> Ed
>
>
>
> Edward I. Galaid, MD, MPH, FACOEM
>
> ABIM, ABPM (OM)
>
> Medical Director, Occupational Medicine
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> Roper Saint Francis Healthcare
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