Administration of measles, mumps, and rubella virus vaccine (live) to egg-allergic children

The measles, mumps, and rubella vaccine (MMR) is grown in chick embryo cell cultures. It is not uncommon for children under one year to be allergic to eggs. The American Academy of Pediatric has recommended that children have a egg skin test prior to receiving this vaccine if an allergic condition is suspected. The MMR vaccine was diluted and used in a skin test for children with a recent history of egg allergy and a positive reaction to the egg skin test. A total of 114 children ranging from 13 to 36 months old were evaluated. Their reactions to the diluted vaccine were compared with reactions to the egg skin test. The prevalence of positive reactions, along with the safety and the efficacy of the vaccine were examined. Of the 114 children, 24 (21.1 percent) reacted positively to the skin test with the diluted MMR vaccine. The probability and severity of the reactions to the egg test were comparable to the degree of reaction to the diluted MMR vaccine skin test. Although a relationship was detected between these two reactions, observations revealed that clinical evidence may not be sufficient to predict the safety of the MMR vaccine. Eleven of the children who previously exhibited respiratory allergy symptoms to egg had negative reactions to the diluted MMR vaccine skin tests; they were successfully vaccinated. Of the total group, 90 children had negative reactions to the diluted MMR vaccine skin test and were safely vaccinated. It was concluded that there exists a specific group of highly sensitive children who react positively to the diluted MMR vaccine. To screen out children with severe allergy it is recommended that the diluted MMR vaccine skin test be given to all children who are egg sensitive.