Influenza Vaccine for Egg-Allergic Patients-- What's safe?

The journal Pediatrics published their report entitled "Safety of Influenza Vaccine Administration in Egg-Allergic Patients." As influenza vaccine manufacturers (except for cell-culture processed vaccine manufacturers such as Novartis) use eggs to to culture the inactive virus, influenza prophylaxis is a concern for individuals with egg allergies. Current guidelines recommend that all people with egg allergies receive a skin test before getting the vaccine; as only 20-30% of the population receives the vaccine as it is, this rate is much lower for people with egg allergies with this additional requirement.

The authors of this article questioned if the current guidelines for egg-allergic people could be loosened, increasing their vaccine utilization. To do this, they conducted a retrospective chart-review study of egg-allergic patients who did receive the skin test or a two dose graded vaccine (which the authors argue can be an alternative option). They found that of the patients who first received the skin test, 95% went on to tolerate the vaccine without serious side effects. Of the 115 patients who did not receive the skin test, 97% tolerated the vaccine without serious side effects. The authors argue that this data suggests that patients with food-allergies (as long as they are without anaphylaxis to egg) can safely receive the two-dose, graded vaccine without the skin test

Do you think these findings support alteration of the current guidelines, in order to increase the rate of vaccination in this population?

Image source: http://discovermagazine.com/2009/jul-aug/27-vaccine-production-horribly-outdated-3-ways-fix-it/vaccine_egg.jpg

Article source: http://pediatrics.aappublications.org/cgi/content/full/125/5/e1024