Measles, mumps and rubella vaccination in children with suspected egg allergy

Abstract

The General Directorate for Health (DGS) has published a recommendation for the administration of measles, mumps, rubella vaccine (MMR) in hospital for patients with a history of anaphylaxis due to egg allergy, previous reaction to MMR, and uncontrolled asthma in patients with documented egg allergy. Objective: To characterize the population referred to hospital for MMR administration regarding compliance with existing referral recommendations, the safety of vaccination in children with suspected egg allergy, and the delay in the administration of the first dose. Type of study: Cross-sectional study of hospital records. Local: Immuno-allergy Department of Dona Estefânia Hospital, Lisbon. Population: Children referred to hospital for MMR administration. Methods: Examination of clinical files over a 5-year period. Results: Of the 83 children referred, 43% had no symptoms upon ingestion of egg. Among the patients who had symptoms, two had a history of anaphylaxis on exposure to eggs and two had controlled bronchial asthma. There was a mean delay of two months in the immunization schedule. None of the patients referred for an MMR booster vaccination had a previous history of reaction to MMR vaccination. No systemic reactions were observed after vaccine administration. Three patients had local, transient skin reactions. Conclusions: The majority of patients referred for MMR vaccination in hospital did not have an allergy to eggs. We found over-diagnosis of food allergy. MMR vaccination was safe, even in cases of patients with a prior history of anaphylaxis on exposure to eggs. After the publication of the DGS recommendation, unjustified hospital referral continues. This causes significant delays in immunization and overloading of hospital services.