Algorithm for Administering the Measles-Mump-Rubella (MMR) Vaccine in Children with Egg Allergy

 

Parameters:

(1) reaction of the child to eating eggs

(2) presence of active, chronic asthma

 

Mild allergic reactions following egg ingestion include:

(1) oral reactions

(2) gastrointestinal reactions

(3) localized urticaria

(4) generalized urticaria

(5) other cutaneous reactions

(6) angio-edema

 

Severe (cardiorespiratory) reactions following egg ingestion include:

(1) difficulty breathing

(2) noisy breathing

(3) stridor

(4) hoarseness

(5) cyanosis

(6) change in consciousness

(7) pallor

(8) hypotension

 

where:

• An anaphylactic reaction to egg ingestion is a severe reaction. It could be a contra-indication to the vaccination.

Reaction to Eating Eggs	Active Chronic Asthma	Action
none	NA	administer vaccination without additional precautions
mild	absent	administer vaccination without additional precautions
mild	present	administer vaccination in the hospital taking all necessary precautions
any severe (cardiopulmonary)	NA	administer vaccination in the hospital taking all necessary precautions

 

where:

• Active, chronic asthma is asthma requiring inhaled steroids or other prophylaxis to control symptoms.

• Most infants who have wheezing caused by a viral infection are not considered as requiring inhaled steroids.

 

If a child does have a reaction to MMR vaccine, then the nature of the allergy needs to be identified. Other constituents in the vaccine (gelatin, antibiotic preservatives, etc.) may be associated with severe allergic reactions.