COVID-19 vaccines and allergies: What you need to know

As the COVID-19 vaccines become available, there are questions about its safety, especially for people with certain allergies. After all there are people who can’t take the flu vaccine. So, allergy experts are taking a close look at this issue and, along with the CDC, have information that can help you know what to expect.

It’s been about a month since people began receiving the COVID-19 vaccine in the United States following its emergency use approval by the U.S. Food and Drug Administration (FDA). So far, about 10.3 million Americans have received at least the first dose of one of the two available COVID-19 vaccines, with at least 541,000 being fully vaccinated.

Right now, those receiving the vaccine are mainly high-risk health care workers and nursing home residents, with people age 75 and older next on the list to get the shots in many states. Nursing homes have been hit especially hard by COVID-19, with their residents accounting for more than a third of the nearly 380,000 COVID-19 deaths in the U.S.

Both of the available vaccines require two doses to be fully effective. The Pfizer-BioNTech vaccine requires doses to be spaced 21 days apart, while the Moderna vaccine needs 28 days between doses. Both vaccines are considered fully active within a week of second dose administration and have been found in studies to provide 95 percent protection against SARS-CoV-2, the virus that causes COVID-19.

There has been a fair amount of concern about reports of possible severe allergic reactions to the COVID-19 vaccines in different countries. To determine whether those concerns are founded, a team of experts led by allergists at Massachusetts General Hospital (MGH) examined all relevant information on the vaccines. What they found may help you with your decision….

COVID-19 vaccine safe for those with (most) allergies

When the vaccine was first approved and administered in the United Kingdom, there were reports of alarming allergic reactions to the vaccine in a few people. This prompted the U.K.’s medical regulatory agency to advise people with a history of anaphylactic reaction to a medicine or food to avoid COVID-19 vaccination.

Anaphylaxis occurs when the immune system reacts to a food, medicine or other substance by releasing a flood of chemicals that cause the blood pressure to drop suddenly and the airway to narrow, cutting off breathing. Common allergens that cause this reaction include foods such as peanuts, medication such as penicillin and substances such as insect venom.

But when the FDA took a closer look at the data related to the allergic reactions, it recommended the COVID-19 vaccines be withheld only from individuals with a history of severe allergic reactions to any of their components. For extra insurance, the Centers for Disease Control and Prevention is advising that all patients receiving the vaccines be observed for 15 minutes afterward by staff who can identify and manage such allergic reactions.

Neither agency recommends people with food or medication allergies avoid vaccination.

Dr. Aleena Banerji, clinical director of the Allergy and Clinical Immunology Unit at MGH, and her colleagues are providing insights from the perspectives of allergists by summarizing what’s currently known about allergic reactions to vaccines like those developed against COVID-19. They’re also giving detailed advice so that individuals with different allergy histories can safely get their first COVID-19 vaccine and outlining steps on safely receiving the second COVID-19 vaccine dose in individuals who develop a reaction to their first dose.

“As allergists, we want to encourage vaccination by reassuring the public that both FDA-approved COVID-19 vaccines are safe,” Dr. Banerji says. “Our guidelines are built upon the recommendations of U.S. regulatory agencies and provide clear steps to the medical community on how to safely administer both doses of the vaccine in individuals with allergic histories.”

According to the panel of experts, allergic reactions to vaccines are extremely rare, with a rate of about 1.3 per 1 million people. They highlight the fact that COVID-19 vaccine clinics will be monitoring all patients for 15 to 30 minutes and can manage any allergic reactions that occur.

Dr. Banerji and her co-authors do recommend that individuals with a history of anaphylaxis to an injectable drug or vaccine containing polyethylene glycol or polysorbate speak with their allergists before getting either of the COVID-19 vaccines. However, they stress it’s perfectly safe for patients with severe allergies to foods, oral drugs, latex or venom to receive the vaccines.

The CDC does advise that if you had had an allergic reaction to other types of vaccines, even if it was not severe, to discuss with your doctor whether or not you should get a COVID-19 vaccine. Your doctor is your best consult when it comes to your medical history.

What to do while waiting your turn

For many of us in the 18-to-64 age range, it’s going to be a while before we’re able to receive any of the COVID-19 vaccines. Until then, here’s what the experts recommend…

• Get plenty of vitamin D. Numerous studies have come out since the pandemic started showing that the great majority of people infected, and who suffer worse outcomes, have vitamin D deficiency. In fact, a group of 120+ health, science and medical experts have signed an open letter to the governments of the world, calling for the “immediate widespread increase” of the consumption of vitamin D. In their letter they state that the association between vitamin D and COVID is “very likely causal, not just correlation.” In other words, it’s not just a coincidence that 80 percent of people infected with COVID-19 have low levels of vitamin D. There appears to be something about the vitamin that thwarts the virus.
• Other dietary interventions that have been recommended include vitamin C, zinc and the omega-3 fatty acid DHA.

Also, continue practicing the behaviors that give you the best chance of avoiding COVID-19 in the first place:

• Wash your hands frequently for at least 20 seconds with soap and warm water. A good way to measure the time is to sing the Happy Birthday song twice while washing.
• Wear a mask whenever you’re outside your home. We’ve talked before about what types of face masks offer the best protection against SARS-CoV-2, but any mask offers better protection than none.
• Avoid large gatherings, especially indoors. When do you meet one or two friends or extended family members, try to make it an outdoor meeting and make sure you wear your masks and keep at least 6 feet apart.

For COVID-19 vaccine info, visit the CDC.

Sources:

Allergists offer reassurance regarding potential allergic reactions to COVID-19 vaccines — Massachusetts General Hospital

See How the Vaccine Rollout Is Going in Your State — The New York Times

COVID-19 Vaccinations in the United States — Centers for Disease Control and Prevention

United States COVID-19 Cases and Deaths by State — Centers for Disease Control and Prevention

Pfizer-BioNTech COVID-19 Vaccine — Centers for Disease Control and Prevention

Moderna COVID-19 Vaccine — Centers for Disease Control and Prevention

COVID-19 Vaccines 101: FAQ — WebMD

Anaphylaxis — Mayo Clinic