TUESDAY, Dec. 15, 2020 — Americans may have questions about possible allergic reactions as immunization with the first COVID-19 vaccine begins, and allergy experts can provide some answers.
The Pfizer COVID-19 vaccine received emergency use authorization from the U.S. Food and Drug Administration on Friday, and distribution of the vaccine began on Monday. But on Dec. 9, soon after the rollout of the vaccine in the United Kingdom, regulators there warned that people with a “significant history” of allergic reactions should not receive the new shot.
The advice was issued after two people suffered adverse reactions on the first day of the U.K. mass vaccination program, the Associated Press reported. The regulators said they are investigating the two cases.
The American College of Allergy, Asthma and Immunology COVID-19 Vaccine Task Force is now offering guidance about the risk of an allergic reaction for people who receive the vaccine, as the U.S. rollout begins.
These recommendations are based on current best knowledge but could change at any time if there is new information and further guidance from the FDA or U.S. Centers for Disease Control and Prevention, the task force noted.
In general, allergic reactions to vaccines are rare, and the incidence of severe allergic reaction (anaphylaxis) is estimated at 1.31 per one million doses.
People with common allergies to medications, foods, inhalants, insects and latex are not more likely than the general public to have an allergic reaction to the Pfizer vaccine. The benefits and risks of the vaccine should be explained to these patients, the task force said.
The vaccine should be given in a health care setting where anaphylaxis can be treated. All people who receive the vaccine must be monitored for at least 20 to 30 minutes after injection for any harmful reactions. Anaphylactic reactions should be treated immediately, with epinephrine as the first-line therapy.
The vaccine shouldn’t be given to people with a known history of a severe allergic reaction to polyethylene glycol, a component of the vaccine known to cause anaphylaxis, according to the task force.
There is limited data about risk to people with a history of allergic reactions to previous vaccinations and/or mast cell activation syndrome/idiopathic anaphylaxis.
The decision about whether to get the Pfizer vaccine should be made by you and your physician or other health care provider giving the shot, based on their professional judgment, the task force advised.
The Pfizer vaccine is not a live vaccine and can be given to people with weakened immune systems. However, these patients might have a weaker immune response to the vaccine, and it’s not known if they will respond to the vaccine and be protected from COVID-19.
If you have questions related to the risk of an allergic reaction to the Pfizer vaccine, contact a board-certified allergist/immunologist, the task force recommended.
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