Dr Animesh Debbarma

This is a very common concern among parents of children with egg allergy. The current evidence and guidelines are reassuring: the MMR vaccine is safe to give to children with egg allergy, including severe egg allergy, and does not require special precautions beyond the standard post-vaccination observation period. The influenza vaccine, which does contain small amounts of egg protein, may require a 30-minute observation period in children with a history of severe egg-related anaphylaxis, but is also generally considered safe. Yellow fever vaccine is the one where egg allergy does require specific assessment before administration. I discuss the child's specific allergy history and advise accordingly at each vaccination visit.

Distinguishing allergy from infection is something I am asked about constantly. The key differences are in the nature, timing, and duration of symptoms. Allergic rhinitis typically produces persistent clear watery discharge, sneezing in runs, nasal itch, and itchy or watery eyes  -  and it may be seasonal or triggered by specific exposures like dust or pets, without fever. Recurrent infections produce coloured or thick discharge, are often associated with fever, and typically resolve within 10 days before returning. A child who seems to have a continuous cold that never fully resolves, with clear discharge and no fever, almost certainly has allergic rhinitis rather than repeated infections.

Inhaler refusal is one of the most common practical challenges I help families with. The most important first step is ensuring the right device is being used for the child's age  -  young children need a valved spacer with an appropriately sized face mask, not a metered dose inhaler used directly. Technique matters enormously: the spacer allows the child to breathe normally rather than coordinating a precise inhalation. Making the process part of a calm, consistent routine rather than a confrontation helps significantly. I demonstrate technique at every consultation and encourage parents to practice with the child at home when symptoms are absent, so that the inhaler feels familiar rather than threatening.

Allergy evaluation can begin from infancy. Eczema and food allergy may present in the first months of life, and clinical assessment for these conditions is possible from very early on. Skin prick testing and specific IgE blood tests can be performed in young infants where clinically indicated. Allergic rhinitis and asthma are more commonly identified from around 2 to 3 years of age when breathing patterns can be more reliably assessed. If your child has recurrent skin rashes, persistent cough or wheeze, reactions to foods, or chronic nasal symptoms at any age, an allergy evaluation is worthwhile regardless of how young they are.