Why people with allergies should not worry about the Covid-19 vaccine

Pollens, nuts, dust, shellfish or penicillin are among the allergens that many people fear being exposed to. Depending on the allergy, what follows is sometimes a skin reaction, sneezing, chest tightness, or anaphylaxis. In some rare cases that may be fatal if not treated immediately. 

With vaccination gaining speed around the world, people with a history of allergic reactions now ask: Could the vaccine be dangerous for them?

Experts say, they shouldn't worry too much. The fear of side effects shouldn't deter people from getting vaccinated. Here’s why:

• Allergic to one is not allergic to all

For Chest Diseases Specialist Prof Dr Muhammed Emin Akkoyunlu, it’s important to understand that anyone can be allergic to anything, including food, cosmetics or a smell. People should avoid receiving inoculations only if they have been tested and proven to be allergic to one of the ingredients of a vaccine.

In Turkey, where Sinovac's CoronaVac vaccine is widely being used, a tweet went viral saying that a health worker who’s allergic to penicillin had an anaphylactic attack 15 minutes after receiving a jab. “She was allergic to penicillin...She was about to die while trying not to get sick,” her daughter said. She later recovered after a quick treatment. 

Many people with penicillin allergies began wondering whether they would react to the Covid-19 vaccine.

But connecting the penicillin allergy with anaphylactic shock in such an event would be a medical misinterpretation, Akkoyunlu tells TRT World. This kind of reaction is extremely rare, reported with a frequency of about one in a million, and doesn’t make vaccines more dangerous than any other material we are exposed to for the first time. 

According to the American College of Allergy, Asthma and Immunology, people with common allergies are not more likely than the general public to have an allergic reaction to the Pfizer-BioNTech Covid-19 vaccine. That’s a sentiment Akkoyunlu echoes.

“Being allergic to a substance doesn't mean that you’ll be allergic to others,” he says.

“This could be a reaction against the vaccine itself or a specific ingredient a vaccine contains,” he says, adding that each vaccine can possibly trigger light reactions.

• A 30-minute observation is key 

What if people turn out to be allergic to one of the active ingredients of a vaccine? This factor can be addressed with proper education and observation, says Prof Dr Ismail Balik, the head of the infectious diseases department at Ankara University School of Medicine.

“That’s why the vaccines should be received in a health institution where the health personnel are available for immediate response. It’s a procedure that is applied with all drugs that are approved for emergency use,” Balik tells TRT World. 

Centers for Disease Control and Prevention (CDC) recommends anyone receiving a vaccine to be observed for at least 15 minutes, and people with allergies should be observed for at least 30 minutes. Experts also suggest people with allergies should inform doctors at the vaccination sites about their medical condition.

“The most feared allergic reaction, which is also seen when patients react to penicillin, is anaphylaxis. This reaction may be deadly if it’s left intervened. But when it’s immediately treated in a healthcare facility, it’s not deadly and leaves no permanent damage,” Balik says. 

The Professor also points out that around 50 million doses of different kinds of vaccines have been used around the world, and no deaths have officially been recorded as a direct result of the inoculations. Officially reported side effects on the other hand are tolerable and they largely don’t require hospitalisation, as they tend to disappear within two days, he says.  

Twenty three elderly people in Norway, and 10 in Germany have died after receiving Pfizer's Covid-19 vaccine. However, a direct link has not been found between the vaccination and the deaths. On average, 400 people die each week in nursing homes and care facilities combined in Norway. In Germany, too, the people who died after receiving vaccines were aged between 79 and 93.

• The first dose will tell it all 

One of the most common ones are the Pfizer-BioNTech and Moderna Covid-19 vaccines. Both are categorised as Messenger RNA vaccines—also called mRNA vaccines. It means encoding the spike protein found on the surface of SARS-CoV-2, the virus that causes Covid-19, the Centers for Disease Control and Prevention (CDC) explains.

Traditional vaccines on the other hand rely on the method of using a small part of the virus itself, or the whole virus, to inject into the body to trigger an immune response. Another widely used vaccine CoronaVac developed by the Chinese company Sinovac is the most widely used vaccine approved for emergency use using this technique. 

Pfizer excluded people with a history of anaphylaxis from its clinical trials, but that wasn’t the case for the Moderna vaccine. There is no official decision around the world about excluding people with a history of allergic reactions from vaccination.

In the US, however, the patients who have previously received cosmetic facial fillers are being warned that they may observe some side effects, FDA warned. 

In Turkey, the health ministry said those who experience a reaction other than expected common reactions after receiving a vaccine won't receive a second dose. 

The decision is based on the fact that the most severe kind of allergic reaction would occur in the second dose, Akkoyunlu says. 

“In the first shot, the body perceives a foreign substance. Then the shot would be when the body reacts greatly, if an allergy is developed,” he says.