Covid-19 Vaccines and Allergies

Yes, allergy to penicillins is not a contraindication to the Pfizer/BioNTech or AstraZeneca COVID-19 vaccine or Moderna vaccine

If you have a history of immediate onset anaphylaxis to multiple classes of drugs or unexplained anaphylaxis – please also refer to the additional information at the end of these FAQs.

In the Green Book the British Society for Allergy and Clinical Immunology (BSACI) has advised that:

‘Individuals with a localised urticarial (itchy) skin reaction (without systemic symptoms) to the first dose of a COVID-19 vaccine should receive the second dose of vaccine with prolonged observation (30 minutes) in a setting with full resuscitation facilities (e.g. a hospital)’

No, according to the manufacturer, neither the Pfizer/BioNTech COVID-19 or AstraZeneca or Moderna vaccine vial contains latex.

The Pfizer/BioNtech vaccination is supplied in vials that have a stopper made from Bromobutyl. This is a synthetic form of rubber which does not contain any dry natural rubber (latex). Pfizer have confirmed that latex is not used at all in the raw materials used to produce the vaccine.

The AstraZeneca vaccination is supplied in vials that have a stopper made from Halobutyl which is also a synthetic form of rubber which does not contain any dry natural rubber (latex)

The Moderna vaccination is supplied in vials that do not contain any dry natural rubber (latex)

It is important to let your Healthcare Provider know about your latex allergy so they can ensure they do not use any latex containing products whilst treating you.

The latest information in the Green Book states:-

‘Following close surveillance of the initial roll-out, the MHRA has advised that individuals with a history of anaphylaxis to food, an identified drug or vaccine, or an insect sting CAN receive any COVID-19 vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine. All recipients of the Pfizer BioNTech COVID-19 vaccine should be kept for observation and monitored for a minimum of 15 minutes. Facilities for management of anaphylaxis should be available at all vaccination sites.’

If you have a history of immediate onset anaphylaxis to multiple classes of drugs or unexplained anaphylaxis – please also refer to the additional information at the end of these FAQs.

Neither the Pfizer/BioNTech or the AstraZeneca or Moderna vaccine contain any egg proteins and none of the vaccines are contraindicated in egg allergy.

Yes, allergy to aeroallergens such as house dust mites, pollen or animal allergens is not a contraindication to the Pfizer/BioNTech or the AstraZeneca COVID-19 or the Moderna vaccine.

The number of true allergic reaction to vaccines is very low. In the United Kingdom, only 1 case of anaphylaxis per million vaccine doses was reported between 1997 and 2003 (with no fatalities). Data for the rate of true allergic reactions to the Pfizer/BioNTech , Astra Zeneca and Moderna vaccines is still being collected but is likely to be low compared to the incidence of anaphylaxis to medicines in general.

Many common side effects of vaccination such as localised pain and swelling at the site of injection or flu-like symptoms can be mistaken for allergy. They are not a reason to avoid the Pfizer/BioNTech or AstraZeneca COVID-19 vaccine or Moderna vaccine.

The Green Book states:-

‘The Pfizer BioNTech COVID-19 mRNA Vaccine BNT162b2 contains polyethylene glycol (PEG), which is from a group of known allergens commonly found in medicines and also in household goods and cosmetics. Known allergy to PEG is extremely rare but would contraindicate receipt of this vaccine. (Sellaturay P et al, 2020). Patients with undiagnosed PEG allergy may have a history of unexplained anaphylaxis or of anaphylaxis to multiple classes of drugs.  The AstraZeneca vaccine does not contain PEG and is a suitable alternative.

PEG is also an excipient in the Moderna mRNA COVID-19 vaccine; individuals who have a systemic allergic reaction to the Pfizer-BioNTech vaccine should not be given a dose of the Moderna vaccine, and vice versa.’

The Astra Zeneca COVID-19 vaccine contains Polysorbate 80; this additive is found in many vaccines including the influenza vaccine.  Although Polysorbate 80 is quite similar in structure to PEG, there are no reports of PEG allergic patients reacting to it e.g. when receiving other vaccines and therefore the Astra Zeneca vaccine is recommended as a suitable alternative.

Allergy to Poylsorbate 80 is extremely rare but would contraindicate receipt of the Astra Zeneca vaccine.  Polysorbate 80 allergic patients should discuss their allergy with an allergist/ immunologist before receiving the Pfizer/BioNTech or Moderna COVID-19 vaccine.

Yes, there is no need to avoid the Pfizer/BioNTech COVID-19 or AstraZeneca or Moderna vaccines if you have had a mild to moderate reaction to a food or an identified drug.

If you have a history of immediate onset anaphylaxis to multiple classes of drugs or unexplained anaphylaxis – please also refer to the additional information at the end of these FAQs.

No, there is not. However good asthma control in the weeks before vaccination is important (just like with all other vaccines).

Yes, allergy to venom is not a contraindication to the Pfizer/BioNTech or the AstraZeneca or Moderna COVID-19 vaccines.

The latest information in the Green Book states :-

‘Following close surveillance of the initial roll-out, the MHRA has advised that individuals with a history of anaphylaxis to food, an identified drug or vaccine, or an insect sting CAN receive any COVID-19 vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine. All recipients of the Pfizer BioNTech COVID-19 vaccine should kept for observation and monitored for a minimum of 15 minutes. Facilities for management of anaphylaxis should be available at all vaccination sites.’

If you have a history of immediate onset anaphylaxis to multiple classes of drugs or unexplained anaphylaxis – please also refer to the additional information at the end of these FAQs.

No. The ingredients for each vaccine are listed in the patient information sheet which you should be given to read prior to having your vaccination. There is no gelatine in the Pfizer/BioNTech or AstraZeneca or Moderna vaccines.

You are correct that squalene is used in some vaccines. It is highly purified fat that does not contain the proteins which cause the allergic reaction. It is not considered to pose any risk for patients with fish allergy.

Neither the Pfizer/BioNTech or AstraZeneca or Moderna vaccination contain any squalene and there is no reason to suspect that they would cause any problems for someone allergic to fish.

All people who carry adrenaline should take their two auto injectors with them everywhere they go. Anaphylaxis to a vaccine is extremely rare. Public Health guidelines require anyone responsible for giving a vaccine to receive training on the management of anaphylaxis.

A protocol for the management of anaphylaxis and an anaphylaxis pack which includes adrenaline must always be available whenever vaccines are given.

There are many COVID-19 vaccines in development with several in the final stages of trials and likely to become available over the coming months. Each vaccine is different, and they use a variety of different technologies. Until a vaccine is approved, we will not know exactly what the ingredients are, so it is impossible to comment on their safety or otherwise for people with particular allergies.

Before having any vaccination, it is important that you are given the patient information leaflet to read. This contains vital information about who should receive the vaccine along with a complete list of ingredients.