The COVID-19 Task Force does not anticipate any contraindication for patients on allergen immunotherapy (AIT). However, it would be best to not get the two shots within 48 hours of each other to avoid confusion should a reaction occur.

Managing severe reactions to mRNA COVID 19 vaccines

The CDC has updated their guidance on administration of the SARS-CoV-2 mRNA vaccines with respect to pre-vaccine risks and post-vaccine reactions. Contraindications to either of the mRNA vaccines now include immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components (Pfizer-BioNTech, Moderna), including polyethylene glycol (PEG).

  • Immediate allergic reaction is defined as any hypersensitivity-related signs or symptoms such as urticaria, angioedema, respiratory distress (e.g., wheezing, stridor), or anaphylaxis that occur within four hours following administration.
  • Individuals with a history of immediate allergic reaction to any component of an mRNA COVID-19 vaccine should not be vaccinated unless they have been evaluated by an allergist/immunologist and it is determined that the person can safely receive the vaccine (e.g., under observation, in a setting with advanced medical care available).
  • Individuals with an immediate allergic reaction to the first dose of an mRNA vaccine should not receive additional doses of either of the mRNA COVID-19 vaccines.
  • Individuals with a history of food, pet, insect, venom, environmental or latex allergies are able to proceed with vaccination with a standard 15 minute observation period.
    • Vial stoppers of mRNA vaccines are not made with natural rubber latex
    • The mRNA vaccines do not contain egg or gelatin
  • Those with a history of severe allergic reaction (e.g. anaphylaxis) to an injectable medication should use caution when receiving the vaccine and follow a 30-minute observation period.
  • These articles provide additional information on reactions:
    • Maintaining Safety with SARS-CoV-2 Vaccines (NEJM, December 30)
    • Allergic Reactions Including Anaphylaxis after Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine – United States, December 14-23, 2020 (MMWR, January 6)
  • There are multiple systems for monitoring adverse reactions to the COVID-19 vaccine (December 10, 2020)