CDC Issues Guidance & Study on Allergic Reactions to COVID-19 Vaccine

By now, you’ve probably heard the two available COVID-19 vaccines—Pfizer-BioNTech and Moderna—have triggered allergic reactions, including anaphylaxis, in some individuals.

While these reactions represent a small subset of vaccinated individuals, we wanted to share the latest recommendations and findings given its relevance to the food allergy community.

The CDC recently issued guidance for individuals with a history of anaphylaxis or severe allergic reactions, and advised that individuals with non-vaccine-related allergies—specifically referencing food, pets, latex, or the environment—receive the vaccination. They further advised that anyone with a history of anaphylaxis or severe allergic reactions to a vaccine or “injectable medication” should first consult their doctor. Individuals with an allergy to any of the ingredients in the vaccine listed below, including polyethylene glycol (PEG) or its close relative polysorbate, are advised not to receive either of the currently available mRNA COVID-19 vaccines.

Vaccination providers are additionally advised to take certain precautionary measures, such as having epinephrine and antihistamines on-site and monitoring individuals with a history of severe allergic reactions for at least 30 minutes—the standard monitoring period is at least 15 minutes.

Based on data from a CDC report published last week, allergic reactions have been rare. The below report focused on the Pfizer-BioNTech vaccine, and a report on allergic reactions to the Moderna vaccine is forthcoming.

As of December 23rd, 1,893,360 doses of the Pfizer-BioNTech vaccine had been administered and 4,393 adverse reactions were reported. Of those, 21 were identified as anaphylactic allergic reactions, 86 as non-anaphylactic allergic reactions, and 7 are under review as possible allergic reactions. Among the 21 anaphylaxis cases, 17 had documented histories of allergies or allergic reactions, and 20 had either recovered or been discharged home.

While the rate of anaphylaxis cases for the Pfizer-BioNTech COVID-19 vaccine is higher than the flu vaccine—11.1 cases per million and 1.3 cases per million, respectively—Dr. Nancy Messonnier, Director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters on a recent conference call that “even at 11 cases per million doses administered, it’s a very safe vaccine.”

Messonnier added “tremendous efforts” were underway to try to understand why these vaccines are triggering severe allergic reactions.

— Abi and the Allergy Amulet Team