Allergic reactions to the coronavirus vaccine: Should I be concerned? – San Francisco Chronicle

Welcome to Pandemic Problems, an advice column from The Chronicles engagement reporters that aims to help Bay Area residents solve their pandemic-related conundrums personal, practical or professional. Send your questions and issues to pandemicproblems@sfchronicle.com.

Todays question is fielded by The Chronicles Kellie Hwang.

Dear Advice Team: After learning that the two U.K. health care workers who were given the Pfizer-BioNTech vaccine had allergic reactions and had to use epinephrine auto-injectors, Im wondering if it will be safe for me to get the vaccine once its my turn. I have atrial fibrillation, so if I had an allergic reaction to the vaccine, Im not supposed to use epinephrine. Also, I have allergies and eczema, and get skin rashes if I eat the wrong thing. Should I be concerned?

Dear Reader:

Im sure a lot of people with allergies and other health problems are wondering if the vaccine will be safe for them. I also have allergies and carry an EpiPen with me, so Ive been very curious too.

First, a little background.

Earlier this month, two health care workers experienced anaphylactic reactions after receiving the Pfizer vaccine, and had to use auto-injectors to inject themselves with epinephrine (known popularly in the U.S. by the brand name EpiPen). Since the vaccine rollout began in the U.S. and thousands have been vaccinated, a handful of people also developed allergic reactions in multiple states.

Iris Otani, an allergist and immunologist at UCSF, said vaccine reactions are quite rare and occur in about 1.3 per 1 million doses given. Most flu vaccines, for example, use egg-based technology so people with egg allergies may be concerned about getting them. But the CDC has said even individuals with severe allergies can receive a licensed, age appropriate flu vaccine.

The FDA posted a fact sheet for the Pfizer vaccine that includes the ingredient list. Otani noted that one ingredient in the Pfizer vaccine that has caused prior reactions in individuals is polyethylene glycol.

While the FDA hasnt determined the culprit yet, polyethylene glycol is a top suspect. Individuals with a polysorbate allergy could also react to polyethylene glycol, according to Otani. The National Institutes of Health launched a study to find out why some people have severe reactions to the Pfizer vaccine.

So, who could be at risk?

Those who have a history of anaphylaxis but not to a vaccine and also not specifically to the COVID vaccine are at lower risk, Otani said. Those with a history of reactions to vaccines, even if not the COVID vaccine itself, are at more moderate risk. Individuals who have a history of anaphylaxis to components of COVID vaccine are definitely at high risk.

The CDC says that individuals with a severe reaction to any ingredient in a COVID-19 vaccine should not get the vaccine. And anyone with a severe reaction to the first dose should not get a second dose.

Otani said individuals at risk for reactions to vaccines should speak to their doctor or, ideally, an allergist about receiving a coronavirus vaccine. Depending on the reaction history, allergy testing for vaccines or vaccine ingredients like polyethylene glycol may be appropriate. And vaccine administration sites should have precautions in place for the possibility of allergic reactions.

Currently the observation period recommended by the CDC is 30 minutes after the vaccination if an individual has a history of anaphylaxis due to any cause. Those with severe allergies should have their EpiPens on hand just in case. All other vaccine recipients should be observed for 15 minutes after receiving the shot for any adverse reactions.

Otani said epinephrine is the only medication that can reverse severe allergic reaction symptoms. Also known as adrenaline, it can cause palpitations and other side effects. But she said that if somebody really needs an EpiPen, she recommends they use it.

And when in doubt? Talk to your doctor. They know your medical history the best.

Kellie Hwang is a San Francisco Chronicle staff writer. Email: kellie.hwang@sfchronicle.com Twitter: @KellieHwang

Pandemic Problems is written by Chronicle Advice Team members Annie Vainshtein and Kellie Hwang, combining thorough reporting and guidance from Bay Area experts to help get answers and find a way forward.

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Pandemic Problems, an advice column from The Chronicles engagement reporters, aims to help Bay Area residents solve their pandemic-related problems personal, practical or professional. Writers Annie Vainshtein and Kellie Hwang combine thorough reporting and guidance from Bay Area experts to help get answers and find a way forward.

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Allergic reactions to the coronavirus vaccine: Should I be concerned? - San Francisco Chronicle