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Allergy/Immunology


Answer 2
  1. Proceed with the vaccination. Contrary to popular belief, egg allergy is not a contraindication to use of the MMR vaccine.2 Contraindications include anaphylaxis to a prior MMR vaccination, anaphylaxis to neomycin, or a history of gelatin allergy. In cases of prior anaphylaxis to eggs (not observed in the case patient), the patient should be observed for 90 minutes after receiving the vaccine. Skin prick testing prior to vaccination is not recommended because it is not predictive of development of a hypersensitivity reaction to the vaccine.3 Neither desensitization to egg nor using incremental doses of vaccine has a role in management in this case.

    REFERENCES
    2.
     Gunn VL, Nechyba C, editors. The Harriet Lane handbook: a manual for pediatric house officers. 16th ed. Philadelphia: Mosby; 2002.

    3. Watson JC, Hadler SC, Dykewicz CA, et al. Measles, mumps, and rubella-vaccine use and strategies for elimination of measles, rubella, and congenital rubella syndrome and control of mumps: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morbid Mortal Wkly Rep 1998;47(RR-8):1-57.

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