1.Measles-Mumps-Rubella vaccine for children with egg allergy: Is admission for inpatient vaccination necessary?
Tan Mei See ; Teoh Ewe Jin ; Hor Chee Peng ; Angeline Yeoh Aing Chiee
The Medical Journal of Malaysia 2016;71(4):157-160
Introduction: Children who develop any hypersensitivity
reaction to eggs are routinely referred to hospital for
Measles-Mumps-Rubella (MMR) vaccination as inpatients to
prevent anaphylaxis. We aimed to study the association
between hypersensitivity reactions after egg exposure and
similar reactions after MMR immunisation; and examine the
necessity of hospital admission for vaccination.
Methods: A prospective observational study was conducted
in Paediatric Department in Bukit Mertajam Hospital,
Penang, between March and December 2014. Children
referred from local polyclinics for inpatient MMR vaccination
because of a history of egg allergy were recruited. The
children were observed in the ward for post vaccination
allergic reactions. Concurrently, a group of children without
egg allergy was recruited from those admitted for other
illnesses but had recent MMR vaccination at polyclinics.
Parents of these children were interviewed and asked if they
had observed any reactions post vaccination. In both
groups, sociodemographics, medical history and family
history of atopy were collected.
Results: Eighty-seven subjects were recruited in this study.
Fifty-four infants with egg allergy had previous mild allergic
reactions after exposure to eggs or egg-related products.
They were associated with a family history of egg
hypersensitivity, personal history of acute gastroenteritis
and upper respiratory tract infections. Two of them
developed cutaneous rashes post vaccination during
observation, but none developed anaphylactic or
anaphylactoid reactions. Two infants among those without
egg allergy had post vaccination fever. There was no
association between egg allergy and hypersensitivity
reactions to MMR vaccine (p=0.632).
Conclusions: MMR vaccine can be safely administered to
children with mild egg allergy, hence admission for
vaccination in the hospital is not warranted. Risk
stratification is required to ensure only infants with severe
reactions will be admitted for vaccination.
Measles-Mumps-Rubella Vaccine