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9.) A 67-year-old woman comes to the physician for her first influenza virus vaccination. She has a history of untreated hypertension. Her blood pressure is 160/100 mm Hg, and pulse is 100/min. Shortly after administration of the influenza virus vaccine, she develops shortness of breath, hives, and angioedema. Which of the following is most likely to have prevented this reaction?


A) Inquiry about an egg allergy
B) Heterophile agglutination test
C) Skin test with histamine reagent
D) ß-Adrenergic blocking agent therapy
E) Amantadine therapy
F) Insulin therapy
G) Rimantadine therapy

It's an NBME question from form 2
I looked online and most people put A
but I highly doubt that's the correct answer because I remember reading something on the lines of egg embryo being used for influenza vaccine so
there's no contraindications to using influenza vaccines in people with an an egg allergy
the egg allergy exception applies to mostly the MMR vaccine if I remember correctly

what do you guys think?

Much appreciated
 

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The correct answer is A.

In recent years it has been found that most egg-allergic patients need no precaution while given a flu shot.
References:
http://www.medpagetoday.com/Pediatrics/Vaccines/19384
http://www.medscape.com/viewarticle/719947

However the CDC still recommends that the best way to avoid such a reaction is by simply asking the patient if they can tolerate eating eggs.
Reference:
http://www.cdc.gov/flu/professionals/acip/adversetiv.htm

If the patient has history of severe egg allergy then you can do a skin test (option C) but still the first thing to do is (option A)
 
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