Immunisation: egg allergy and measles-containing vaccine: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Immunisation: egg allergy and measles-containing vaccine

Sample item

A 12-month-old developed hives after eating egg. She is now due for the measles-containing vaccine. What is the appropriate advice?

AGive it only after a negative skin test to eggBDefer the vaccine until 5 years of ageCGive the vaccine routinely, as egg allergy is not a contraindicationDGive it only as graded divided doses in hospital

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Give the vaccine routinely, as egg allergy is not a contraindication

The measles-containing vaccines are grown in cell cultures and contain negligible egg protein, so egg allergy, even anaphylaxis, is not a contraindication. True contraindications are a previous severe allergic reaction to a vaccine component such as gelatin or neomycin, and severe immunodeficiency. Delaying leaves the child exposed to measles.

Option by option

A. Give it only after a negative skin test to egg
Egg skin testing is not required and does not predict reactions to the vaccine.
B. Defer the vaccine until 5 years of age
Deferral to 5 years exposes the child to measles for no benefit.
C. Give the vaccine routinely, as egg allergy is not a contraindication (correct)
Correct. Egg allergy does not prevent routine measles-containing vaccination.
D. Give it only as graded divided doses in hospital
Graded dosing in hospital is not needed for egg allergy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Give the vaccine routinely, as egg allergy is not a contraindication. The measles-containing vaccines are grown in cell cultures and contain negligible egg protein, so egg allergy, even anaphylaxis, is not a contraindication.

Why is "Give it only after a negative skin test to egg" not the answer?

Egg skin testing is not required and does not predict reactions to the vaccine.

Why is "Defer the vaccine until 5 years of age" not the answer?

Deferral to 5 years exposes the child to measles for no benefit.

Why is "Give it only as graded divided doses in hospital" not the answer?

Graded dosing in hospital is not needed for egg allergy.

What concept does this question test?

It tests Immunisation: egg allergy and measles-containing vaccine in Pediatrics. True contraindications are a previous severe allergic reaction to a vaccine component such as gelatin or neomycin, and severe immunodeficiency. Delaying leaves the child exposed to measles.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunisation: egg allergy and measles-containing vaccine?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.