MMR
VACCINATION of CHILDREN ALLERGIC TO EGG
Chow WC, Kwan EYW, Lau YL
Department of Paediatrics, University of Hong Kong, SAR,
China
Objective: Measle virus in MMR or single measle vaccines are grown in
culture of fibroblasts from chick embryos. Small amount of egg protein is
present in the vaccine. First Anaphylactic reaction to MMR was first
identified in 1983 and was associated with the egg allergy. However, recent
studies did not confirm a definite causal relation of the egg allergy and
MMR anaphylaxis. The objectives of this study were to evaluate the
recommendations of MMR vaccination of children known to be allergic egg,
and to document any association between egg allergy with MMR vaccine
anaphylaxis in our locality.
Methods: This study was a retrospective review of all patients admitted
into our hospital for MMR vaccination during the period of Jan. 1996 to
Dec. 2000.
Results: 146 patient records were reviewed and the male to female ratio
was 79/67. Only 96 patients got history of egg allergy. Most of them did
not know whether they were sensitive to egg white or egg yolk. Seven cases
out of the 96 patients showed anaphylactic reaction to egg component.
Others suffered from minor reactions such as rash or urticaria. All
patients were given MMR vaccine and none of them developed anaphylaxis.
Only two patients got non-specific rash soon after the injection. All cases
were discharged on the same day after the injection and no mortality
detected.
Conclusions: MMR vaccination is as safe as any other vaccine and allergy to
eggs should not delay measle vaccination. Children with milder forms of
allergy can be safely vaccinated without additional precaution. All
vaccination must be carried out in setting equipped to deal with
anaphylactic reaction. Further investigation and formation of registry with
full reporting of allergy and reaction clearly defined would be most
helpful in understanding the
causes of MMR allergy.