COVID-19 and vaccines

COVID-19 vaccination programmes in the UK continue but are now targeted to specific groups — for example older adults, people who are immunosuppressed, and care-home residents — rather than the universal mass roll-outs seen earlier in the pandemic. Seasonal/ autumn vaccination campaigns are planned each year and eligibility is published by the JCVI/NHS.

Anaphylaxis UK does not have any information about the regional availability of different vaccines. If you are struggling to access a vaccine please speak to your GP.

Yes. A history of food allergy on its own is not a contraindication to COVID-19 vaccination.

People with food or environmental allergies — including those who have had anaphylaxis to foods — can usually be vaccinated in routine settings and do not normally require specialist allergy assessment beforehand. Specialist review is recommended only for people with suspected allergy to a vaccine component (for example polyethylene glycols (PEG) or those who had a clear immediate anaphylactic reaction to a previous dose of a COVID-19 vaccine.

The Green Book makes clear that very few people cannot receive the COVID-19 vaccines authorised in the UK. Where there is doubt, clinicians should seek expert advice rather than routinely withholding vaccination. The Green Book guidance states:

Relative contraindications / situations needing specialist input

• People who have had a previous anaphylaxis to a COVID-19 vaccine.

• People with a known allergy to a vaccine component (for example PEG).

• People with a history of immediate anaphylaxis to multiple different drug classes, or anaphylaxis to medicines likely to contain PEG (these histories can indicate possible PEG allergy and should prompt referral).

• People with idiopathic anaphylaxis or with prior anaphylaxis to a vaccine, injected antibody or medicine likely to contain PEG.
  Where a specialist advises that vaccination may be given, this is usually done under medical supervision (for example, in hospital) with appropriate observation. In contrast, if someone has previously tolerated the same vaccine without significant reaction, future doses can usually be given in any standard vaccination setting.

Table 5 in the Green Book helps staff decide whether to vaccinate in a routine setting, to take special precautions, or to refer for specialist review. Healthcare professionals can refer to this table for advice on how to manage patients with allergies. No specific management is required for patients with a family history of allergies.

Observation practices have changed more recently: routine prolonged observation (for example a blanket 15-minute wait for everyone) is no longer required for people with no history of allergy in some vaccination protocols — but people with specific allergic histories may still be observed for longer (e.g. 30 minutes) depending on clinical assessment. Vaccination sites must continue to be able to recognise and treat anaphylaxis promptly. If someone previously had a severe immediate allergic reaction to a COVID-19 vaccine, further doses should only be considered following specialist review and usually in a hospital setting.