A study released January 6 by the U.S. Centers for Disease Control and Prevention (CDC) concluded that the risk of anaphylaxis – a severe, potentially life-threatening allergic reaction – from the vaccine is extremely low.
This is not your typical itching. Anaphylaxis symptoms include wheezing, difficulty breathing, swelling of the throat and tongue, sometimes accompanied by nausea, vomiting, and diarrhea. Yes, this can happen but very rarely.
Based on data from people who have received the first of the two recommended doses, only about 1 in every 90,000 people, on average, will experience this adverse reaction.
For a better perspective on how are this is – in the United States, the odds of one dying from choking on food is around 1 in 2,696. Also in the US, the odds of being struck by lightning in a lifetime (estimated 80 years) is one in 15,300. To be clear, this is just with the mRNA vaccines that have been rolled out in many parts of the world now, including the US and Europe.
The risk of anaphylaxis is far smaller than the negative outcomes associated with COVID-19 infections, especially among the elderly. By October 2020, the disease became one of the leading causes of death in the U.S. among people more than 45 years old.
To date, the pandemic has killed over 373,000 Americans. With a population of 328 million, this means that COVID-19 has killed more than one out of every 1,000 Americans. I can’t emphasize it enough but clearly, the benefits of getting the vaccine significantly outweighs the risk, even with the very rare chance of anaphylaxis.
Experts in allergology and immunology offer guidance on COVID-19 vaccines for those with allergies. A review published in the Journal of Allergy and Clinical Immunology: In Practice provides an outline of what is known about immediate allergic reactions associated with m-RNA-based vaccines and offers guidelines on how patients with potential reactions should be managed.
To ensure that the vaccines are administered as quickly as possible and that patients with a prior allergy history receive the vaccines safely, experts recommend a risk-stratification protocol that allows for the rapid assessment of patients with concerning anaphylaxis histories.
They also recommend that vaccination clinic staff have education around anaphylaxis treatment guidelines to ensure appropriate treatment and follow-up for patients who have reactions after their first shot, and that patients with a possible allergic reaction after the first shot be prioritized for further testing and support before their second shot.
To ensure a swift response in case of a rare allergic reaction, the US CDC recommends that people need to be observed for 15 minutes after getting the vaccine while those with a history of anaphylaxis or immediate allergic reactions will need to be monitored for 30 minutes. Post-vaccination anaphylaxis should immediately be treated with intramuscular injection of epinephrine. It is important for people with concerns over allergies to consult with their family doctor who are familiar with their medical history.
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Dr. Melvin Sanicas (@Vaccinologist) is a physician-scientist specializing in vaccines, infectious diseases, and global health.