Expert Advice -- MMR vaccine and egg allergy
My son is 18 months and allergic to eggs. I have not allowed his doctor to give him the MMR vaccination, although both she and his allergist are adamant that he will be okay (my son ranked 4 out of 6 on an rast test). They have recommended giving him part of the vaccination, waiting 20 minutes to see how severe the reaction and then if ok, giving him the rest. My instinct is to wait to see if he outgrows the allergy and if he does, give him the vaccination at that time. Am I being too concerned? Does the risk of contracting these diseases outweigh the severe allergic reaction that may occur?
Question:Robert Steele
Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more
You ask an excellent question. The preparation for the measles vaccine involves incubating the virus in cell cultures which contain chicken cells derived from the egg. With approximately 0.5 percent of children having an allergy to eggs, it is estimated that the parents of about 19,000 children in the U.S. have to come up with an answer to the same question: Should I immunize my child with the MMR?
In 1994, the American Academy of Pediatrics recommended that children with allergies to chicken, eggs, or the feathers not receive the MMR until skin testing could be performed. Then, if the skin test are negative, the MMR may be given in the usual manner. If, on the other hand, the skin tests are positive, the vaccine should be given in six doses with each dose having increasing amounts of vaccine in it.
However, since this time, a number of researchers have questioned this policy. The procedure of having the child endure multiple shots taking up to a couple of hours to administrate takes a toll on both the child and the parents. In addition, there had been no direct evidence that children who are allergic to eggs would also have problems with the MMR. Therefore, investigators at Arkansas Children's Hospital and John's Hopkins teamed up to answer this question. In May of 1995, they published their study which showed that children who are allergic to eggs do not seem to be at increased risk for reactions to the MMR. Their study, along with other published studies, have led to the American Academy of Pediatrics to hold discussions about this issue. Although the 1994 policy on the MMR in children with allergy to eggs still stands, it is anticipated that this will be modified sometime soon to allow for all children to receive the MMR without added injections or testing.
My advice to you is to continue your discussion about your fears about the MMR with your doctor, but I am an advocate of giving the vaccine. While it is true that most children outgrow their food allergies, it may be quite a while before this occurs, and in fact, it may never occur. There are still measles outbreaks throughout the U.S. which will put your child at risk of serious disease if he does not receive the vaccine. I agree with your physicians in that the MMR can be given safely and effectively to children who are allergic to eggs. I can certainly understand your apprehension about giving the MMR to your son, and I think I would have shared your concern several years ago. However, I think we now have excellent scientific evidence to show that giving the MMR is safe even in children with egg allergy.
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