Dear patients, We would like to provide you with some information on the subject of allergic reactions to some COVID-19 vaccines.
In the webinar “COVID-19 Vaccines: The Allergology and Immunological Perspective”, which was hosted by GAAPP in December 2021, Purvi Parikh, MD, FACAAI, FACP explains how the different COVID-19 vaccines work, and what their possible side effects for patients with allergies or atopic diseases are. Moreover, she clears up misconceptions about the contraindication of the vaccine for some chronic respiratory and atopic diseases. You can watch the recording or read its summarized content below:
In principle, allergic or anaphylactic reactions can occur in very rare cases (1 case per 100,000 to 1 million vaccinations) with every vaccination (not only against COVID-19). It can be either the vaccine itself or adjuvants/additives in the vaccine that cause the allergic reaction.
There is no evidence of increased risk (compared with the normal population) associated with COVID-19 vaccination with the approved vaccines for patients with the following diseases in the allergic/atopic group:
- Atopic eczema (neurodermatitis)
- Urticaria (hives)/angioedema
- Rhinoconjunctivitis allergica (hay fever)
- Bronchial asthma (but asthma should be well controlled at the time of vaccination)
- Nasal polyps
- Food allergy (especially no problems for chicken egg protein allergy sufferers, as there is no
chicken egg protein in the Biontech or Moderna vaccine)
- Insect venom allergy
- Painkiller intolerance
- Antibiotic allergy
- Contact allergy (e.g. nickel, fragrance, or preservative allergy)
The patient groups listed here do not require a special examination (skin or blood test) prior to vaccination.
Please contact your physician if you have had a severe allergic reaction:
- to a previous non-COVID 19 vaccination,
- following medication (especially laxative solutions) or injections,
- after drugs and known mastocytosis or
- of unknown cause in the past.
Allergic reactions to COVID-19 Vaccines vaccines mean the sudden occurrence of skin symptoms with shortness of breath and/or circulatory reaction, which have required immediate medical therapy. In this case, we advise prior allergic clarification (assessment of the individual situation by an allergist) before COVID-19 vaccination and/or vaccination in increased risk. This includes a 30-minute follow-up. (An emergency kit incl. adrenaline pen must be on-site).
Please note that the ingredients of the vaccine solutions are not available as tested test allergens.
Patients with a known previous severe allergic reaction to ingredients of the vaccine or to the first COVID19 vaccination must not be vaccinated.
Among others, the following ingredients may play a role:
Polyethylene glycol (= macrogol)
Here is some more information on adjunctive therapies:
- Patients receiving treatment for the above diseases (including antibody therapies such as Xolair®, Dupixent®, Nucala®, Fasenra®) can get a COVID-19 vaccine. Currently, the recommendation is that there be approximately 1 week between treatment and vaccination.
- Maintain a minimum interval of one week between administration of subcutaneous hypo-sensitization/specific immunotherapy (SCIT) and COVID19 vaccination, as with all other vaccinations. Clinical experience regarding concurrent vaccination (e.g., with Biontech or Moderna vaccine ) and SLIT treatment has not been documented for many allergen immunotherapeutics. In order to distinguish possible reactions due to COVID-19 vaccination from reactions due to SLIT, according to allergological experience, experts recommend pausing SLIT for at least 1-2 days after COVID-19 vaccination.
- In case of a therapy with immunosuppressants (e.g. Ciclosporin) you should talk to your attending physician beforehand. There seems to be no particular risk from this therapy. However, the vaccination may be less effective.
Check our COVID-19 Statements & Resources for more in-country information.
Source: 1 Worm M et al. Anaphylaxie-Risiko bei Covid-19 Impfung – Empfehlungen für das praktische Management. MMW Fortschr Med. 2021 Jan;163(1):48-52; 2 Klimek L et al. Severe allergic reactions after COVID-19-Vaccination with the Pfizer/BioNTech Vaccine in Great Britain and USA Position Statement of the German allergological Societies AeDA, DGAKI and GPA. Allergo Journal Inter-national 2021; in press; 3 Kleine-Tebbe et al. Schwere allergische Reaktionen auf die Covid-19-Impfung – Stellungnahme und praktische Konsequenzen. Allergologie, Jahrgang 44, Nr. 1/2021, S. 7