American Board of Family Medicine (ABFM) Practice Exam

What is the recommended action for a patient with an egg allergy regarding the influenza vaccine?

1. Avoid giving influenza vaccine

2. Administer the live-attenuated influenza vaccine

3. Administer trivalent inactivated vaccine

4. Have the patient take prednisone before the live vaccine

The correct answer is: Administer trivalent inactivated vaccine

For patients with an egg allergy, the recommended action regarding the influenza vaccine is to administer the trivalent inactivated vaccine. This recommendation is based on a thorough understanding of the influenza vaccine formulations and how they relate to egg allergies. The trivalent inactivated influenza vaccine is produced using eggs, but the majority of patients with egg allergies can safely receive this vaccine without any modifications. Studies have shown that while the vaccine contains trace amounts of egg protein, the risk of anaphylaxis or severe allergic reactions is extremely low for individuals with egg allergies. Therefore, the current guidelines from health authorities support the administration of the inactivated vaccine to those with egg allergies, emphasizing that they should be observed for a brief period after vaccination, particularly those with a history of severe allergic reactions to eggs. In contrast, the live-attenuated influenza vaccine is not recommended for patients with severe egg allergies, as it poses a higher risk due to the potential for a more significant reaction. Additionally, administering prednisone before receiving the live vaccine is not a standard procedure and does not increase safety. Patients with egg allergies are generally advised against the live vaccine unless they have been evaluated and cleared by an allergist. Thus, administering the trivalent inactivated influenza vaccine is the appropriate course of action,