Q&A: Egg Allergy

Egg allergy is one of the most common food allergies in infants and young children but often affects adults as well. Here’s a Q&A to help answer many questions you might have regarding egg allergies including symptoms, triggers, treatments, vaccine safety, and more.

How common is egg allergy?

• An estimated 2.6 million Americans suffer from allergy to eggs;
• Egg allergy is the most common food allergy among children with atopic dermatitis (eczema);
• It is the second most common allergy in infants and young adults after allergy to milk.

[Source: Food Allergy Research and Education]

What are the symptoms of egg allergy?

Egg allergy symptoms usually occur a few minutes to a few hours after eating eggs or foods containing eggs. Signs and symptoms range from mild to severe and can include skin rashes, hives, nasal congestion, and vomiting or other digestive problems. Rarely, egg allergy can cause anaphylaxis — a life-threatening reaction.

[Source: Mayo Clinic]

What part of the egg is responsible for triggering egg reactions?

A majority of people with egg allergies react to ovomucoid and ovalbumin, two proteins found in the egg white. That said, it is impossible to safely separate the yolk from the white so all foods containing eggs must be avoided.

[Source: Healio]

Are eggs from sources other than hens safe for consumption by people with egg allergy?

Quail eggs (69%) and duck eggs (66%) are the most cross-reactive to people with allergy to hen eggs and should be avoided. Unless you have discussed this with your allergist, all avian (bird) eggs should be avoided.

[Source: Healio]

Should I avoid vaccines because of my egg allergy?

The yellow fever vaccine is the only vaccine contraindicated for people with egg allergy. Those with egg allergy interested in receiving the yellow fever vaccine should consult their allergist.

Other common vaccines have been deemed safe for people with egg allergy.

Both the American Academy of Allergy, Asthma & Immunology (AAAAI) and the American College of Allergy, Asthma & Immunology (ACAAI) state that there is now strong evidence that individuals with egg allergy, regardless of severity, can safely receive inactivated or live attenuated influenza vaccine and that the presence of egg allergy is not a contraindication to receive either vaccine. Furthermore, influenza vaccine recipients are at no greater risk for a systemic allergic reaction than those without egg allergy, and vaccine providers do not need to ask about the egg allergy status of influenza vaccine recipients. However, because very low quantities of egg protein are still present, people with egg allergy should remain in the provider’s office for about 30 minutes after receiving the vaccine.

Two new influenza vaccines, one made in mammalian cells (not avian cells) and the other made using recombinant DNA technology, are now available for patients with egg allergies.

A 1995 study published in the New England Journal of Medicine concluded that the MMR (Measels, Mumps and Rubella) vaccine can safely be administered to children with egg allergy, even those with severe hypersensitivity.

[Source: Children’s Hospital of Philadelphia]

The COVID-19 vaccines authorized by FDA are not manufactured using egg products or technology and so pose no issues specific to those with egg allergy.

[Source: Allergy and Asthma Network]

How are tests for egg allergy performed?

Evaluation for egg allergy should be performed by an allergist with experience interpreting allergy test results.

Testing for egg allergy is performed with skin prick testing, where a tiny amount of diluted egg protein is introduced into the skin, or serum-specific IgE tests performed via blood draw.

Home IgG tests have no utility in determining egg allergy, egg intolerance or egg sensitivity. Other non-validated tests for food allergy include saliva and hair analysis, electrodermal tests, kinesiology, and Nambudripad’s Allergy Elimination Techniques (NAET) and are not recommended by the AAAAI.

[Source: Healio]

Are there treatments for egg allergy?

Oral Immunotherapy (OIT) is available from some allergists to help desensitize patients to eggs. OIT involves administering a tiny amount of allergen protein and increasing the dose over time with the goal of increasing the threshold that triggers a reaction. Once the patient reaches the goal dose they must consume a specified amount of egg protein periodically to maintain desensitization.

OIT should never be performed except under strict supervision of an allergist.

[Source: American Association of Allergy, Asthma and Immunology]

Some allergists may also recommend an egg ladder to induce a level of desensitization in eligible patients. An egg ladder is a stepwise process where foods are introduced according to a specific schedule to gradually induce tolerance.

Egg ladders should never be performed except under strict supervision of an allergist.

[Source: Medscape]