AAIQ   The Association of Allergists and Immunologists of Québec

COVID-19 vaccination and allergies

Now that large scale vaccination against COVID has started, some people known to have allergies are wondering if it’s safe to get vaccinated. Although at the beginning of the vaccine campaign in the United Kingdom a recommendation was made to not vaccinate people having severe allergies, this contraindication was removed after analyzing the cases of people having had an allergic reaction to the vaccine. What’s more, even if it seems that vaccination against COVID-19 causes allergic reactions more frequently than other vaccines, the risk remains very low – 11.1 cases of anaphylaxis per million doses, in comparison with 1.3 per million doses for the flu vaccine.

At this moment, concerning allergies, the only contraindication to receiving COVID-19 vaccines is an allergy to their components. The vaccines approved at this moment (Pfizer-BioNTech, Moderna, AstraZeneca and Janssen) don’t contain food or animal proteins, antibiotics, preservatives or latex.

People suffering from food allergies, even serious ones, respiratory allergies (including asthma), insect allergy, antibiotic allergy or an allergy to anti-inflammatories such as aspirin or ibuprofen, an allergy to latex or to anesthetics can receive the vaccines against COVID-19. The same is true for people suffering from chronic urticaria or angioedema.

Only people with a history of allergy to polyethylene glycol (PEG) should be evaluated by an allergist before receiving a vaccine. PEG is found in many laxatives (eg, Lax-A-Day, RestoroLAX) and in several laxative preparations given prior to a colonoscopy (such as Colyte, golytely, Klean-Prep ou Peglyte ). People having had allergic reactions to these products should consult an allergist before receiving any of the currently approved COVID vaccines.

People with a history of immediate allergy (less than an hour after administration) to vaccines containing polysorbate (including flu vaccines) do not need to consult with an allergist and can be vaccinated at vaccination centres. They will receive the Pfizer-BioNTech or Moderna vaccines, since the Janssen and AstraZeneca vaccines contain polysorbate. The observation period after vaccination will be lengthened from 15 to 30 minutes.

People having had an immediate reaction (less than one hour) after receiving a COVID-19 vaccine, or those having a severe reaction in the 24 hours following vaccination must be directed to Public Health for further evaluation.

Note that people who have an autoimmune disease or an immunodeficiency can receive the vaccines approved in Canada against COVID-19. However, it’s possible the COVID-19 vaccines will be less effective in immunosuppressed people. This includes people who suffer from an immunodeficiency or in whom their immune system is weakened by certain medications or illnesses.


Here are links (in French and English) providing the complete list of components of different vaccines against COVID-19:
https://www.msss.gouv.qc.ca/professionnels/vaccination/piq-vaccins/covid-19-vaccin-a-arn-messager-contre-la-covid-19/

Recommendations of the National Advisory Committee on Immunization (NACI) concerning allergies:
https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/recommendations-use-covid-19-vaccines.html#t3

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Marie-Noel Primeau, MD
(translation by Andrew Moore, MD FRCPC)

révisé 12/5/2021