Important note: This article is intended for those who understand vaccines as critical to maintaining their health and that of their families. It is NOT intended for those who are anti-vaccine and as such is NOT intended to foster a discussion on the merits of vaccines in this forum. It is also NOT intended to foster a discussion of the lethality of COVID-19 or the need for civic action to limit the spread of the disease.
As of yesterday, an estimated 4.6 million people in the US have received their first dose of a vaccine according to The New York Times. Here is a map of the rollout indicating the share of the population that has been vaccinated to date:
Of particular concern to the food allergy community is the potential for anaphylaxis upon inoculation with the vaccines. Though no serious reactions were observed during phase 3 trials of either the Pfizer of Moderna vaccines, a small number of anaphylactic events have been reported as the vaccines are rolled out nationwide.
The Centers for Disease Control (CDC) continuously updates their guidance regarding both authorized COVID-19 vaccines as they monitor reports of adverse reactions. The latest guidance was issued last week on December 30.
Excerpts of the most recent guidance that pertain to concerns about anaphylaxis are provided here. You are encouraged to read the guidance in its entirety.
COVID-19 Vaccines and Allergic Reactions
Updated Dec. 31, 2020 — Source: CDC
This webpage provides recommendations on what to do if you experience an allergic reaction after getting a COVID-19 vaccination. It also provides recommendations for people who have had allergic reactions to other vaccines and for those with other types of allergies. This page will be updated when we get new information.
If you get a COVID-19 vaccine and you think you might be having a severe allergic reaction after leaving the vaccination site, seek immediate medical care by calling 911.
If you have a severe allergic reaction to a COVID-19 vaccine
CDC has learned of reports that some people have experienced severe allergic reactions—also known as anaphylaxis—after getting a COVID-19 vaccine. As an example, an allergic reaction is considered severe when a person needs to be treated with epinephrine or EpiPen© or if they must go to the hospital.
If you have had a severe allergic reaction to any ingredient in an mRNA COVID-19 vaccine, you should not get either of the currently available mRNA COVID-19 vaccines. If you had a severe allergic reaction after getting the first dose of an mRNA COVID-19 vaccine, CDC recommends that you should not get the second dose.
If you have a non-severe allergic reaction to a COVID-19 vaccine
CDC has also learned of reports that some people have experienced non-severe allergic reactions within 4 hours after getting vaccinated (known as immediate allergic reactions), such as hives, swelling, and wheezing (respiratory distress).
If you have had an immediate allergic reaction—even if it was not severe—to any ingredient in an mRNA COVID-19 vaccine, CDC recommends that you should not get either of the currently available mRNA COVID-19 vaccines. If you had an immediate allergic reaction after getting the first dose of an mRNA COVID-19 vaccine, you should not get the second dose. Your doctor may refer you to a specialist in allergies and immunology to provide more care or advice.
If you have had an allergic reaction to other types of vaccines
If you have had an immediate allergic reaction—even if it was not severe—to a vaccine or injectable therapy for another disease, ask your doctor if you should get a COVID-19 vaccine. Your doctor will help you decide if it is safe for you to get vaccinated.
If you have allergies not related to vaccines
CDC recommends that people with a history of severe allergic reactions not related to vaccines or injectable medications—such as food, pet, venom, environmental, or latex allergies—get vaccinated. People with a history of allergies to oral medications or a family history of severe allergic reactions may also get vaccinated.
If you have had an allergic reaction to polyethylene glycol (PEG) or polysorbate
These recommendations include allergic reactions to PEG and polysorbate. Polysorbate is not an ingredient in either mRNA COVID-19 vaccine but is closely related to PEG, which is in the vaccines. People who are allergic to PEG or polysorbate should not get an mRNA COVID-19 vaccine.
Safeguards Are in Place
CDC has provided recommendations for COVID-19 vaccination providers about how to prepare for the possibility of a severe allergic reaction:
- All people who get a COVID-19 vaccine should be monitored on site. People who have had severe allergic reactions or who have had any type of immediate allergic reaction to a vaccine or injectable therapy should be monitored for at least 30 minutes after getting the vaccine. All other people should be monitored for at least 15 minutes after getting the vaccine.
- Vaccination providers should have appropriate medications and equipment—such as epinephrine, antihistamines, stethoscopes, blood pressure cuffs, and timing devices to check your pulse—at all COVID-19 vaccination sites.
- If you experience a severe allergic reaction after getting a COVID-19 vaccine, vaccination providers should provide rapid care and call for emergency medical services. You should continue to be monitored in a medical facility for at least several hours.
Learn more about what to expect after getting vaccinated for COVID-19, including normal side effects and tips to reduce pain or discomfort.
CDC Is Monitoring Reports of Severe Allergic Reactions
If someone has a severe allergic reaction after getting vaccinated, their vaccination provider will send a report to the Vaccine Adverse Event Reporting System (VAERS).external icon VAERS is the national system that collects reports from healthcare professionals, vaccine manufacturers, and the public about adverse events that happen after vaccination. Reports of adverse events that are unexpected, appear to happen more often than expected, or have unusual patterns are followed up with specific studies.
Appendix A: Triage of persons presenting for mRNA COVID-19 vaccination
Updated December 30, 2020 — Source: CDC
Moderna COVID-19 Vaccine List of Ingredients
Pfizer COVID-19 Vaccine List of Ingredients
