Reports of possible allergic reactions to COVID-19 vaccines produced by Pfizer-BioNTech and Moderna, both recently approved for emergency use by the United States Food and Drug Administration (FDA), have raised public concern . A team of experts led by allergists at Massachusetts General Hospital (MGH) have now reviewed all the relevant information to provide assurance that vaccines can be given safely, even to people with food or drug allergies. The group’s review is published in the Journal of Allergy and Clinical Immunology: In Practice.
In response to reports of potential allergic reactions in some people following COVID-19 vaccination in the UK, that country’s medical regulatory agency has advised people with a history of anaphylaxis to a drug or food to avoid COVID-19 vaccination. After further reviewing the data relating to allergic reactions, however, the FDA recommended that vaccines be refused only to people with a history of severe allergic reactions to any of the components of the COVID-19 vaccine, and the Centers for Disease Control and Prevention advised that all patients be observed for 15 minutes after vaccination by personnel who can identify and manage these reactions. US agencies do not recommend that people with food or drug allergies avoid vaccination.
To provide insight from the perspective of allergists, Aleena Banerji, MD, Clinical Director of the Allergy and Clinical Immunology Unit at MGH and Associate Professor at Harvard Medical School, and her colleagues summarized what is currently known about allergic reactions to vaccines like those developed against COVID-19, and they have offered detailed advice so that people with different allergy histories can safely receive their first COVID-19 vaccine. They also outline the steps to safely receive the second dose in people who develop a reaction to their first dose of COVID-19 vaccine.
“As allergists, we want to encourage vaccination by reassuring the public that the two FDA-approved COVID-19 vaccines are safe. Our guidelines are based on recommendations from US regulatory agencies and provide clear steps to the medical community on how to safely administer vaccine doses to people with a history of allergies, ”Banerji explains.
Experts note that allergic reactions to vaccines are rare, with a rate of around 1.3 per 1 million people. They also determined that allergic reactions to Pfizer-BioNTech and Moderna COVID-19 vaccines will have an equally low rate of occurrence. They point out that immunization clinics will monitor all patients for 15 to 30 minutes and can manage any allergic reactions that occur. Banerji and his co-authors recommend that people with a history of anaphylaxis from an injectable drug or vaccine containing polyethylene glycol or polysorbate speak to their allergists before being vaccinated. They point out that patients with severe allergies to food, oral medications, latex or venom can safely receive COVID-19 vaccines.
The journal’s co-lead authors are Kimberly G. Blumenthal, MD, MSc, and Brigham and Women’s Elizabeth Phillips, MD. Other co-authors include Paige G. Wickner, MD, Rebecca Saff, MD, PhD, Lacey B. Robinson, MD, MPH, Aidan A. Long, MD, Anna R. Wolfson, MD, and David A. Khan, MD . ; Cosby A. Stone Jr., MD, MPH, of Vanderbilt University Medical Center; and Paul Williams, MD, of Washington University School of Medicine.
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