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Egg hypersensitivity and adverse reactions to measles, mumps, and rubella vaccine
M B Fasano1, R A Wood, S K Cooke
1Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205.
Insights
Children with egg hypersensitivity can safely receive the measles-mumps-rubella (MMR) vaccine. This study found no increased risk of adverse reactions in egg-allergic children, suggesting current guidelines may be overly cautious.
Area of Science:
- Immunology
- Vaccinology
Background:
- The measles-mumps-rubella (MMR) vaccine is a critical public health tool.
- Concerns regarding egg hypersensitivity have led to vaccine administration restrictions.
Observation:
- 140 children with varying degrees of egg hypersensitivity were assessed for MMR vaccine safety.
- Skin testing was performed to evaluate potential allergic responses.
Findings:
- All egg-allergic children tolerated the MMR vaccine safely, irrespective of skin test results or hypersensitivity severity.
- The MMR vaccine contains minimal ovalbumin-like material (approx. 37 pg).
- Two non-allergic children experienced systemic reactions, unrelated to egg protein.
Implications:
- The study supports the safe administration of MMR vaccine to egg-allergic children.
- Current recommendations for skin testing prior to MMR vaccination in egg-allergic individuals may need revision.
- This research can inform updated pediatric immunization guidelines.
Abstract:
We evaluated the safety of the measles-mumps-rubella (MMR) combination vaccine in 140 children with egg hypersensitivity. All children, regardless of vaccine skin test results or severity of egg hypersensitivity, were safely immunized with the MMR vaccine. Systemic reactions to MMR vaccine in two nonallergic children were documented, indicating that reactions unrelated to egg protein can occur. With the use of a competitive enzyme-linked immunosorbent assay, the standard MMR injection was found to contain approximately 37 pg of ovalbumin-like material. This study provides 95% confidence that at least 97.5% of egg-allergic children will tolerate MMR vaccine without significant difficulty. Skin testing was not found to be helpful in predicting an adverse reaction. We recommend that the American Academy of Pediatrics consider revising its current policy regarding skin test response to MMR vaccine and administration of MMR vaccine to egg-allergic children.