All UK general paediatricians will be familiar with the following letter: “Dear Doctor, This child is due for mumps–measles–rubella vaccine but eggs bring him out in a rash and his parents are anxious; could you carry out the immunisation on the ward?”

 Advice from standard texts such as theBritish National Formulary, the UK Department of Health Green Book, and the American Academy of Pediatrics Red Book are inconsistent; manufacturers' product inserts have varied over the years. With the aim of providing evidence based practical guidance on the subject, ADC commissioned Lakshman and Finn from the Sheffield Institute for Vaccine Studies, to produce information that our readers could follow and safely pass on to their colleagues in primary care (page 93).

Their answer to the quoted letter would seem to be straightforward: egg allergy is not what really counts. Rather, all vaccinations—not just that with MMR—must be carried out in settings with equipment and personnel to deal with anaphylaxis. All general practice surgeries …