Can people with allergies take the COVID vaccine?

Published February 17, 2021, 5:22 PM

by Analou de Vera

PH Society of Allergy, Asthma and Immunology clarifies issues on adverse reactions

The Philippine Society of Alergy, Asthma and Immunology assured the public that the benefits of COVID-19 vaccines far outweigh the potential risks of adverse reactions.

•       The Philippine Society of Alergy, Asthma and Immunology said that the benefits of COVID-19 vaccines far outweigh the potential risks of adverse reactions.

•       There are two kinds of possible reactions: Reactogenic and allergic reaction.

•       Examples of reactogenic reactions include pain and swelling in the injection site that occurs within the first three days.

•       An allergy or hypersensitivity reaction is an exaggerate immune response to a usually harmless substance.

•       People with allergy to food such as egg; allergy to inhalant allergens (such as) dust mites, pollens, pets; to insects; those with eczema, those patients with controlled asthma whether they are inhalers or not; those patients with allergic rhinitis whether they are on nasal sprays or not; patients with history of urticaria; patients who have history of rashes to oral medications can receive the vaccine.

An army health worker prepares a dose of Covishield, AstraZeneca/Oxford’s Covid-19 coronavirus vaccine made by India’s Serum Institute, at an army hospital in Colombo on January 29, 2021. (Photo by Ishara S. KODIKARA / AFP / FILE PHOTO / MANILA BULLETIN)

While people are waiting for the arrival of the vaccines against COVID-19, many stories about the vaccine – from the experiences of those who have already been given the second jab, to questions on who can be given the vaccines are crowding digital media.

The Philippine Society of Allergy, Asthma, and Immunology (PSAAI) on Feb. 11 conducted a virtual forum titled “Allergies and COVID–19 Vaccines: A Heart to Heart Talk” to clarify the issues that are related to allergies.

The  main speakers were PSAAI President Dr. Rommel Crisenio M. Lobo and Dr. Maria Carmen D. Ang, a PSAAI member.

In the forum, Dr. Ang assured the public that the benefits of COVID-19 vaccines far outweigh the potential risks of adverse reactions. “Based on current data, the benefits of receiving the COVID-19 vaccine far outweigh the risk of an allergic reaction,” she said.

Here are some of the issues related to allergies which were discussed by PSAAI doctors during the webinar:

Reactogenic reaction and allergic reaction

According to Dr. Ang, reactions to COVID-19 vaccine may occur, but not all reactions are allergic.

“Majority of the reactions are reactogenic. This means that since the vaccines stimulate the immune system, they may cause side effects. Reactogenic reactions are not the same as allergic reactions,” she said during the media forum.

(Daniel Schludi / UNSPLASH / FILE PHOTO / MANILA BULLETIN)

The official statement of PSAAI posted on their website explained: “A reactogenic reaction is an inflammatory, response that occurs after vaccination.”

In the forum , Dr. Ang said: “Examples of reactogenic reactions include pain and swelling in the injection site that occurs within the first three days. It can be systemic like headache, muscle pain, fever and chills, vomiting, tiredness, and body aches.”

Dr. Ang said that those reactions are usually gone within one to three days and can be managed with  paracetamol, pain relievers, hydration, or cold compress.

Anaphylaxis

On the other hand, “allergy is an exaggerated immune response to a usually harmless substance,” said Dr. Ang. Anaphylaxis is a type of severe allergic reaction.

The PSAAI statement in its website explained: “Anaphylaxis, which is a severe type I reaction, is rare with an estimated incidence of 11.1 per 1million doses of mRN COVID-19 vaccines. The incidence of anaphylaxis to other covid-19 vaccines is currently unknown.”

(Photo by Dogukan Keskinkilic / FILE PHOTO / MANILA BULLETIN)

In the forum, Dr. Ang explained: “Patients who develop anaphylaxis can have two or more organs involved and these may result in developing symptoms such as rashes or hives, difficulty breathing, abdominal pain, vomiting, swelling of the face, low blood pressure, fast heart beat.” Anaphylaxis usually happens within the first 15 to 30 minutes after injection.

However, Ang said that “severe allergic reactions are rare.” She said that “mild allergic reactions are managed with antihistamines. Anaphylaxis is rare and (this is) managed with epinephrine.”

Dr. Ang and Dr. Lobo said that they have not heard of deaths due to anaphylaxis that can be linked to COVID-19 vaccines.

People with allergies

Ang said that people with allergy to food, inhalant allergens, among others, can take the COVID-19 vaccine.

“Patients with allergy to food such as egg; allergy to inhalant allergens (such as) dust mites, pollens, pets; to insects; those with eczema, those patients with controlled asthma whether they are inhalers or not; those patients with allergic rhinitis whether they are on nasal sprays or not; patients with history of urticaria; patients who have history of rashes to oral medications can receive the vaccine,” she said.

Allergic reaction to other vaccines

Meanwhile, patients who had “an immediate allergic reaction to other vaccines other than the COVID-19 vaccines and other injectable medications, need further evaluation by an allergist/ immunologist if they can receive the COVID-19 vaccine or not,” said Ang. 

This file photo taken on January 08, 2021 shows empty bottles of Pfizer-BioNTech Covid-19 vaccine at the Emile Muller hospital in Mulhouse, eastern France.
(Photo by SEBASTIEN BOZON / AFP / FILE PHOTO / MANILA BULLETIN)

“If they are cleared for vaccination, they should be observed for at least 30 minutes,” she said. 

Who should not receive the second dose of COVID-19 vaccines?

The patients who had mild or severe allergic reactions to the first dose are advised not receive the second dose, said Dr. Ang.

“Patients with immediate allergic reaction whether mild to severe, such as anaphylaxis, after the first dose of COVID-19 vaccine should not receive the second dose,” said Ang.

A health worker holds a vial of Russia’s Sputnik V (Gam-COVID-Vac) Covid-19 vaccine in Belgrade Fair turned into a vaccination centre, on February 4, 2021.
(Photo by Andrej ISAKOVIC / AFP / FILE PHOTO / MANILA BULLETIN)

“Those patients with a history of allergic reactions to any component of the COVID-19 vaccine, such as polyethylene glycol (PEG) or polysorbate should not receive the vaccine as well. These patients should be referred to an allergist or immunologist for further evaluation,” she added.

Those who experienced reactogenic reactions
PSAAI President Dr. Rommel Lobo said that those who experience reactogenic reactions (injection site pain, among others) should take the second dose of COVID-19 vaccines.

Vaccination sites ready for patients with allergic reactions

The PSAAI said that healthcare workers who will be manning the vaccination sites are trained to manage allergic reactions. Vaccine recipients will be first screened by the health workers before the vaccine will be injected to them.

“Yes, they are trained in recognizing and giving the first intervention which is your epinephrine. Firstly, you will not be vaccinated right away. In the vaccination site, the doctors and nurses there have a checklist to screen vaccinee if they are fit to be vaccinated,” said Dr. Lobo.

“Epinephrine will be made available in the vaccination centers.  Patients who undergo vaccination will be observed for 30 minutes. If during the 30 minutes, the doctor there would say that the patient is having anaphylaxis, then epinephrine will be injected and the patient will be brought to the nearest (hospital) ER (emergency room),” said Dr. Maria Carmela Kasala, a member of PSAAI.

(The complete position statements of the PSAAI on COVID-19 vaccines and adverse reactions are published in its website.)

 
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