H1N1 (Swine Flu) and Food Allergy

in Food Allergy
Published: July 2, 2010

Background: The vaccine against the H1N1 flu (formerly known as swine flu) is now available in Canada and the U.S.

Frequently Asked Questions:

Q. Does the H1N1 vaccine contain egg?

A. The H1N1 vaccine for Canada was developed by GlaxoSmithKline using the egg-based production method. This means the vaccine viruses are grown in eggs. This is true for the regular flu shot as well.

The manufacturer states the level of ovalbumin (egg protein) in the adjuvanted vaccine is generally below 5-10 ng/mL. The ovalbumin level is not yet available for the unadjuvanted version of the vaccine, which is offered to pregnant women.

In an official statement to physicians, the CSACI allergist organization says the risk of a reaction to the H1N1 vaccine (or the regular flu vaccine) in most egg-allergic patients appears to be quite low, when proper risk-reduction measures are in place.

Dr. Wade Watson says people who have had a recent or serious reaction to egg should contact their allergist to discuss their options. Lower-risk individuals can get their vaccine at a regular clinic, as long as there is a doctor’s supervision, access to epinephrine, and the egg-allergic person is observed after being given the shot. In fact, the vaccine should always be given under observation, regardless of a previous history of allergic reaction.

For greater detail on assessing egg allergy risk and risk-reduction measures, please see the CSACI official position paper. In the U.S., the Centers for Disease Control has issued similar advice to those who’ve had serious egg allergic reactions. It can be read here.

Q. Have any studies been done on egg allergies and the vaccine?

A. A group of allergists in Quebec are studying the tolerance of the H1N1 vaccine in egg-allergic individuals. The CMAJ website reported on December 3rd that in a trial of 952 people, none had an anaphylactic reaction to the shot. Two had skin reactions treated with Benadryl.

See: December Update

Q. Are there other allergy concerns with the vaccine?

A. In Canada, the vaccine adjuvant (called AS03) contains two ingredients that have been of some concern to people with allergies. (See: Vaccine Ingredients) The first is squalene, derived from shark liver oil. Both Dr. Richard Warrington, president of the CSACI, and a representative from GlaxoSmithKline, the makers of the vaccine, say there is NO risk to people with fish allergy.

Squalene is a fat, and it is protein that causes allergic reaction. Furthermore, the squalene is highly purified and any protein traces will have been removed. Dr. Warrington also adds that the antibodies found in fish allergic subjects show very limited cross-reactivity with shark protein.

The second ingredient that has raised concern is tocopherol (vitamin E) which is sometimes derived from soybean oil or seeds. A representative from GlaxoSmithKline states that the tocopherol in the adjuvant is synthetic, and does not contain any plant- or animal- derived components or proteins.(See: Vaccine Ingredients)

Q. If my child can’t receive the vaccine, can he/she still be protected from H1N1?

A. If your child is unable to receive the H1N1 vaccine for allergy reasons, there are other measures that can be taken to protect him or her from contracting the flu, says Dr. Sharon Dell, an expert in airway diseases at the Hospital for Sick Children in Toronto. For one, she suggests that if all the other members of the child’s family get the vaccine, than that would provide some protection.

Furthermore, “meticulous hand washing” and avoiding contact with other people who are sick will also help.
If the child has reacted to a previous vaccine, but it’s unclear what the cause of the reaction was, he or she could be skin-tested to this particular vaccine first, and could receive the vaccine if there’s no indication of reaction.

Allergic Living Disclaimer:
This information contained is designed as a public service and is not intended as a substitute for the advice of a medical doctor/specialsit. AGW Publishing Inc. (publisher of Allergic Living) disclaims any warranty arising from this information and will not be held liable for damages arising from reliance on the content contained herein.

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