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Prevention
A new report released by the Centers for Disease Control and Prevention (CDC) found that although serious allergic reactions to the COVID-19 vaccine can occur, they are rare. The report, which was released on January 6, found that the risk of developing a serious allergic reaction after the vaccine is 0.001%, based on data available to date.
The news follows warnings that people with a history of serious allergic reactions to vaccines or injectable drugs should speak to their doctor before receiving the COVID-19 vaccine. The Allergy and Asthma Network and the CDC say you should tell your health care provider if you’ve had anaphylaxis, a serious and life-threatening allergic reaction that can cause breathing difficulty, to a previously injected drug or vaccine.
However, people with a history of severe allergic reactions do not Related to vaccines or injectable drugs – such as food, animal, venom, environmental or latex allergies – should always be vaccinated, according to the CDC.
The advice followed after a few people reported reactions to the vaccine in the United States. An Oregon health care worker was hospitalized after suffering from Pfizer vaccine anaphylaxis; a Boston doctor with a history of shellfish allergy also felt dizzy and heart pounding after receiving the Moderna vaccine.
It’s important to at least be aware of these potential reactions, even if they are rare, says Jamie Alan, Pharm.D., Ph.D., assistant professor of pharmacology and toxicology at Michigan State University. “Some concern is justified, although it should not automatically sway someone [to not get vaccinated]Alan says. “This is not a new concern, because an allergic reaction to all the vaccine is always a risk. “
This raises big questions, especially if you have a history of allergies. Here’s what you need to know, according to the experts.
How common are severe allergic reactions to the COVID-19 vaccine?
The recent report released by the CDC analyzed data from the vaccine adverse event reporting system between December 14 and 23, when the first 1,893,360 doses of the Pfizer-BioNTech vaccine were administered. Of these patients, 21 developed anaphylaxis. The report also found that 71% of these reactions occurred within 15 minutes of immunizing patients, which is the time that healthcare providers recommend that you wait in their office to see if you develop a disease. reaction. However, the period during which people experienced this severe allergic reaction ranged from two minutes after vaccination to 150 minutes after vaccination.
Of the 21 people who developed anaphylaxis after being vaccinated, 17 had a history of allergies or allergic reactions and seven had a history of anaphylaxis. The CDC was able to find follow-up information on 20 of the patients with anaphylaxis and found that all had recovered or were being sent home.
There were also other less serious allergic reactions. CDC researchers found that 86 people had what they categorized as “non-anaphylactic allergic reactions,” which can include hives to minor swelling. As a safety measure, the agency urges healthcare providers to have epinephrine (epinephrine in the form of EpiPen) and equipment to open a person’s airways in the event of a severe allergic reaction.
Overall, the report’s results are promising, says Richard Watkins, MD, an infectious disease physician and professor of medicine at Northeast Ohio Medical University. They show that “the vaccine is safe and effective,” he said, adding that “the risks of COVID-19 far outweigh those of the vaccine.”
What causes an allergy to a vaccine?
Typically, a person is allergic to a specific component of a vaccine, not at all. “It’s often a preservative or, in the case of the flu vaccine, it can be residual egg protein,” says John Sellick, DO, infectious disease expert and professor of medicine at the University of Buffalo / SUNY in New York.
The CDC specifically lists the potential causes of allergic reactions to vaccines:
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The vaccine antigen
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Residual animal protein
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Antimicrobial agents
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Preservatives
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Stabilizers
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Other components of the vaccine
Overall, however, the preservative used (thimerosal, for example) is the most common potential allergen, according to Purvi Parikh, MD, an allergist in the Allergy & Asthma Network. “Usually, preservative-free vaccines are well tolerated,” she says.
Is there a way to know if you will be allergic to the COVID-19 vaccine you are receiving?
The Pfizer and Moderna vaccines have not been tested on people with a history of severe allergies due to obvious concerns about the potential for life-threatening reactions, says Stanley Weiss, MD, professor at Rutgers New Jersey Medical School and the Rutgers School of Public Health epidemiology department.
He explains that generally “people who have a history of allergic reactions have a higher risk of reacting to something new”.
If you’re allergic to a particular ingredient, like glycerin, and it’s in a vaccine, you’ll likely have a reaction, says Dr. Sellick. The same is true for people with allergies to eggs. “If you knew ahead of time that you had anaphylactic reactions to eggs, I wouldn’t want to give you an egg-based flu shot,” he says. (There are, however, versions without eggs.)
After the Pfizer and Moderna vaccines obtained emergency use approval from the FDA, the two companies released their complete list of vaccine ingredients. It is not known at this point what people have had a severe allergic reaction to in either vaccine, but lipid polyethylene glycol (one of the fats used to wrap mRNA to make sure it is delivered to cells) is potentially suspect, says Alan.
Unless you compare your known allergies to the ingredients in the vaccine, it can be hard to tell if you’ll have an allergic reaction to a vaccine, “especially if it’s the first time you’ve received it,” says Robert Weber, Pharm.D . , Administrator of Pharmacy Services at Ohio State University’s Wexner Medical Center and Assistant Dean of Medical Center Affairs at the Ohio State University College of Pharmacy. Unfortunately, there is “no way” to know for sure if someone with a history of allergies will have a severe allergic reaction to the COVID-19 vaccine.
So who should and shouldn’t get the COVID-19 vaccine?
Right now, the Allergy and Asthma Network says people should “be careful” if they have a history of anaphylaxis from another vaccine or from an injected drug, and should not receive the vaccine if they have a history of anaphylaxis to any of the components of the available COVID-19 vaccines. People who are allergic to polyethylene glycol or polysorbate in particular should not receive a vaccine, according to the CDC. (Polysorbate is not found in Pfizer and Moderna vaccines, but is closely related to polyethylene glycol.)
If you had an allergic reaction right after your first dose, you should not be given the second dose, according to the CDC. Instead, your doctor may refer you to an allergy specialist.
The CDC also recommends talking to your doctor if you’ve had an immediate allergic reaction to a vaccine or injectable treatment for another condition in the past, even if it wasn’t serious, such as hives or swelling. . “If someone has a problem, they should always talk to their doctor,” says Dr. Sellick. Most doctor’s offices have a policy on this, but they recommend staying a little while after you’ve been vaccinated, so they can help you if you have a reaction. (The CDC recommends 15 minutes if you have no history of allergies and 30 minutes if you do.)
❗If you have received the COVID-19 vaccine and think you are having a severe allergic reaction after leaving the vaccination site, see a doctor immediately.
If you are getting vaccinated in a location other than your doctor’s office, make sure the person giving you your vaccine is aware of your personal allergy history. Once the vaccine becomes more widely available, “if an allergist is worried, they can do a skin test and challenge you with all or half of the vaccine under medical supervision in their office,” says Dr. Parikh.
Bottom Line: Experts point out that serious allergic reactions to vaccines are extremely rare, and getting the vaccine is an important step in ending the coronavirus pandemic, so when in doubt, speak to your doctor. They can guide you on the next best steps. “I’ve been administering vaccines for 20 years and have probably given 10,000 vaccines,” Weber says. “I haven’t seen a single serious reaction.”
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