Tdap Vaccine is NOT Contraindicated in Egg Allergy
Tdap (tetanus, diphtheria, and acellular pertussis) vaccine can be safely administered to individuals with egg allergy without any special precautions, as Tdap vaccines do not contain egg protein and are not manufactured using eggs. 1
Key Evidence Supporting Safe Administration
Tdap vaccines are not egg-based vaccines. The contraindications for Tdap listed in authoritative guidelines include only a history of serious allergic reaction (anaphylaxis) to vaccine components or a history of encephalopathy within 7 days of previous pertussis-containing vaccine administration—egg allergy is not mentioned as a contraindication or precaution. 1
Egg allergy concerns are specific to certain vaccines only. The vaccines that require consideration of egg allergy are those grown in chick embryos or embryonic tissues, specifically: influenza vaccines, yellow fever vaccine, and certain rabies vaccines. 1
MMR/MMRV vaccines, despite being produced in chicken-embryo fibroblasts, are safe even for those with severe egg allergy because the egg protein content is negligible. 1, 2 This demonstrates that even vaccines with theoretical egg exposure can be safe—and Tdap has no such exposure at all.
Clinical Algorithm for Tdap Administration
For patients with egg allergy requiring Tdap:
- Administer Tdap using standard protocols without any modifications 1
- No skin testing with vaccine is required 1
- No special observation period beyond standard post-vaccination monitoring (15 minutes for syncope prevention) is needed 1
- No dose splitting or graded administration is necessary 1
Important Distinction: Actual Tdap Contraindications
The only true contraindications to Tdap are: 1
- History of anaphylaxis to any component of the Tdap vaccine itself (not egg, as egg is not a component)
- Encephalopathy within 7 days after previous pertussis-containing vaccine not attributable to another cause
Precautions (not contraindications) include: 1
- Guillain-Barré syndrome within 6 weeks of previous tetanus toxoid-containing vaccine
- Progressive or unstable neurologic disorder
- History of severe Arthus-type hypersensitivity reaction after previous tetanus or diphtheria toxoid-containing vaccine
Common Pitfall to Avoid
Do not confuse egg allergy considerations for influenza vaccines with Tdap. The confusion likely arises because both are commonly administered vaccines, but their manufacturing processes are entirely different. Influenza vaccines are produced in embryonated chicken eggs and may contain trace egg protein, while Tdap vaccines are not. 1