My friends at ConsumerLab.com have a great update on the COVID vaccine and all the allergies you’ve been hearing about. Below are some details. I use this information to answer questions my patients have about taking th COVID vaccine with a history of allergies to anything.
But first, today’s news on the risk of an severe allergic reaction:
CDC reports 21 cases of anaphylaxis following administration of Pfizer’s coronavirus vaccine
USA Today reports that in early data, the CDC “detected 21 cases of anaphylaxis, a severe allergic reaction, after receiving the Pfizer-BioNTech COVID-19 vaccine,” according to the agency’s Morbidity and Mortality Weekly Report.
Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said there were 21 cases out of 1,893,360 doses administered between December 14 and December 23, meaning there were 11.1 cases of anaphylaxis per 1 million vaccinations.
Dr. Messonnier said while this is a higher rate of anaphylaxis than is typical with the flu vaccine, 1.3 cases per 1 million doses, the rate for the coronavirus vaccine means it is still considered a rare outcome.
Reuters reports the CDC also reported a single case of anaphylaxis in an individual who received Moderna’s coronavirus vaccine. The agency said it will continue carefully monitoring allergic reactions to the coronavirus vaccines made by Pfizer and Moderna.
A history of allergic reactions: The Advisory Committee on Immunization Practices (ACIP) of the CDC recommends the following contraindications and precautions for people with a history of allergic reactions:
- Those who have a severe allergic reaction to the first dose of the COVID-19 vaccine should not receive a second dose.
- Those who have a severe allergic reaction to any ingredient in the mRNA COVID-19 vaccines should not be vaccinated unless an allergist-immunologist has determined that the vaccine would be safe for that individual. To find out more about the ingredients in these vaccines, see the Consumer Lab table.
- In particular, people should not receive the COVID-19 vaccines if they have a known severe or immediate allergic reaction to PEG. This ingredient is included in both the Pfizer and Moderna vaccines. Although it is still unclear which of the vaccine components have caused the reported severe allergic reactions in people who were vaccinated, some experts have speculated that PEG may be the cause (de Vrieze, Science 2020).
- Keep in mind that PEG is already an ingredient in numerous other medicines, including certain laxatives (e.g., MiraLAX) and bowel preparations for colonoscopies, as well as certain injectable contraceptives (e.g., Depo-Provera), steroids (e.g., injectable methylprednisolone), and some chemotherapy drugs (e.g., Doxil).
- The PEG in many of these medicines is higher molecular weight (i.e., a bigger molecule) compared to the PEG in the vaccines, and there is some evidence that the risk of sensitization is higher with higher molecular weight PEG (Castells, N Engl J Med 2020).
- Due to potential cross-reactive hypersensitivity, people with known allergies to PEG-like molecules such as polysorbates should also not receive the vaccines unless an allergist-immunologist has approved the vaccination.
- Polysorbate 80 is an ingredient in the AstraZeneca COVID-19 vaccine, which is already in use in the U.K. and may be authorized in the U.S. in early 2021.
- In addition, polysorbate 80 is in other adenovirus-based vaccines such as certain Tdap (diphtheria, tetanus, pertussis), hepatitis A and B, HPV (human papillomavirus), influenza, meningococcal, pneumococcal, and rotavirus vaccines, as well as one of the shingles vaccines (CDC, Vaccine Excipient Summary).
- People who have had anaphylaxis to any other vaccine or injectable therapy should be counseled by their healthcare professional on the unknown risks of developing a severe allergic reaction to help weigh the risk and benefits.
- If they choose to be vaccinated, they should be observed for 30 minutes afterward.
- No contraindications or precautions:
- People with
- food allergies,
- pet allergies,
- allergies to medicines taken by mouth,
- environmental allergies, or
- latex allergies
- may receive the COVID-19 vaccines.
- food allergies,
- People with a history of anaphylaxis due to any of these causes should be monitored for 30 minutes after vaccination.
- People with a history of allergic reactions but not anaphylaxis should be observed for 15 minutes after vaccination.
© Copyright WLL, INC. 2021. This blog provides a wide variety of general health information only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment from your regular physician. If you are concerned about your health, take what you learn from this blog and meet with your personal doctor to discuss your concerns.
- People with