InfluenzaV accination of People with a History of Egg Allergy • Most influenza vaccines, with the exception of recombi- Recommendations regarding influenza vaccination nant influenza vaccine (RIV4) and cell culture-based of persons who report allergy to eggs – Advisory influenza vaccine (ccIIV4), are cultured in eggs and Committee on Immunization Practices, United States, might contain trace amounts of egg protein (e.g., 2020–21 influenza season ovalbumin).

• People with a history of egg allergy who have experi- Administer any recom- enced only urticaria (hives) after exposure to egg should After eating eggs or mended, and age-appro- egg-containing foods, receive influenza vaccine. Any recommended and age- yes priate IIV, RIV4, or LAIV4 does the person appropriate influenza vaccine (i.e., any IIV, RIV4, or that is otherwise appro- experience only hives? priate for the persons’s LAIV4) that is otherwise appropriate for their health sta- health status tus may be used. no

• People who report having had reactions to egg involving symptoms other than urticaria (hives), such as angio- After eating eggs or edema or swelling, respiratory distress, lightheadedness, egg-containing foods, or recurrent vomiting, or who required epinephrine or does the person experi- Administer any IIV, RIV4, ence other symptoms or LAIV4 that is other- another emergency medical intervention, may similarly such as wise appropriate for the receive any recommended, and age-appropriate influ- • Angioedema? person’s age and health enza vaccine (i.e., any IIV, RIV4, or LAIV4) that is other- status in a medical set- wise appropriate for their age and health status. If a vac- • Respiratory distress ting (e.g., health depart- (e.g., wheezing)? cine other than ccIIV4 or RIV4 is used, the selected ment, physician office). yes vaccine should be administered in a medical setting (e.g., • Lightheadedness? If a vaccine other than ccIIV4 or RIV4 is used, clinic, health department, physician office) and super- • Recurrent emesis vaccination should be vised by a healthcare provider who is able to recognize (e.g., nausea/vomit- ing)? supervised by a health- and manage severe allergic conditions. care provider with experi- • Reaction requiring ence in the recognition • A previous severe allergic reaction to influenza vaccine, epinephrine? and management of regardless of the component suspected of being respon- • Reaction requiring severe allergic condi- sible for the reaction, is a contraindication to future emergency medical tions. receipt of the vaccine. attention?

• Regardless of allergy history, all vaccines should be administered in settings in which personnel and equip- ment for rapid recognition and treatment of anaphylaxis are available.*

abbreviations references = IIV Inactivated Influenza Vaccine (Afluria Quadrivalent, Fluad, * CDC. Best practices guidance of the Advisory Committee on Immu- Fluad Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, nization Practices Committee (ACIP). Access at Fluzone Quadrivalent) www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html ccIIV4 = Cell-cultured inactivated influenza vaccine (Flucelvax Adapted from CDC. “Prevention and Control of Seasonal Influenza Quadrivalent) with Vaccines: Recommendations of the Advisory Committee on Immu- RIV4 = Recombinant Influenza Vaccine (Flublok Quadrivalent) nization Practices – United States, . . . Access links to current recom- mendations at www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html LAIV4 = Live Attenuated Influenza Vaccine (FluMist Quadrivalent)

Saint Paul, Minnesota • 651-647-9009 • www.immunize.org • www.vaccineinformation.org www.immunize.org/catg.d/p3094.pdf • Item #P3094 (9/20)