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Dr. Tim Says....

Egg Allergy

one whole brown egg and one brown egg that has been cracked open, with the yolk of the egg remaining in the egg's cup

Egg allergy is a very common allergy in children, affecting 1.6%-2.5%. Almost all children with egg allergies develop a tolerance to eggs by age 5, however. Although the specific proteins causing the allergic reaction are generally found in the egg whites, allergic patients must avoid egg yolks as well because it is impossible to separate the two. 

The most common egg allergen is known as ovomucoid. It generally remains allergy-causing when cooked, although many of the other, minor allergens in eggs can be tolerated by affected patients after cooking. Unfortunately, there are many hidden sources of eggs, and those who are allergic should be careful to read nutrition labels. Some of the more common hidden sources of egg include marshmallows, mayonnaise, meringue, baked goods, breaded foods, marzipan, frostings, processed meat, meatloaf, meatballs, puddings and custards, salad dressing, pasta, pretzels, and fresh baked bread from a bakery.1

Data does suggest that kids with certain allergies can become less sensitive as they age. How and when one might reintroduce egg into the diet depends on how severe of the allergy. Children with mild allergies whose symptoms are limited to mild skin rashes or hives may be tested by eating fully cooked egg around ages 2-3. The best, safest process for reintroducing egg to those with severe egg allergy has not yet been well established and should not be tried at home - it's best to discuss this with your pediatrician or allergist. Children with any severe or systemic reaction or history of asthma should be prescribed an epinephrine auto-injector (EpiPen). Again, ask your physician if you should have one for your child. 

Always tell your doctor if you believe you or your child is allergic to eggs, as egg proteins are found in several vaccines, including influenza, yellow fever, and MMR. The amounts of allergens are extremely low, however: for example, influenza vaccines contain just 0.02 to 1.0 micrograms and the variation depends on the brand and batch. MMR, on the other hand, contains 40 picograms (1 milligram equals 1,000,000,000 picograms). Even though the amounts of allergens are so small, the CDC recommends modifications to the vaccine schedule for patients with a history of egg allergy, and you should discuss this with your pediatrician.

That said, those who are able to eat lightly cooked eggs or baked goods without reaction may receive their vaccinations according to the standard schedule. If your child experiences only hives when they eat eggs, they may also receive the vaccine on the regular schedule, but should remain under observation for thirty minutes after receiving the vaccine. Children with more severe egg allergy symptoms should be referred to a specialist for further evaluation prior to vaccination. Vaccination is vitally important to your child's health: discuss any concerns you might have with your physician.

1. Mayo Clinic Staff. Egg allergy: Prevention.

Timothy S. Harlan, M.D.
Dr. Gourmet