COVID VACCINE ALERT
Please be aware that we recommend patients do not receive allergy shots of biologics injections for 7 days after receiving a COVID vaccine. This may cause a need to reschedule an injection appointment. Please call our office to change appointment times or for any questions or concerns. You can also contact us through the patient portal.
We do not expect to be a site for administration of the COVID19 vaccine. Please check with your local public health department.
Use this link for more information on the state of California’s tiered system for vaccine administration.
Frequently Asked Questions
What is vaccine allergy?
Similar to medications or foods, people can be allergic to a vaccine. However, allergic reactions to vaccines are very rare (about 1 in 1 million people will have an allergic reaction to a vaccine). Some reactions are mild, such as hives as the only symptom, while others are more severe. A severe allergic reaction is called anaphylaxis. Symptoms start very quickly (usually within minutes) and almost always within 4 hours of vaccination and typically include multiple parts of the body: hives on the skin; swelling of mouth, lips, tongue or throat; shortness of breath, wheezing, or chest tightness; or low blood pressure or loss of consciousness. About half of allergic reactions to vaccines happen in the first 15 minutes after receiving the vaccination.
What about redness and swelling at the injection site- is that an allergic reaction?
Sometimes vaccines can cause large local reactions at the injection site, and these can begin hours after the vaccination or even the next day. The skin at the site of vaccination can become sore, swollen, red, and painful. Sometimes it can also become itchy. The symptoms can last several days. Although this type of reaction can be uncomfortable, if it does not include the symptoms of allergic reactions listed above, it is not an allergic reaction to the vaccine, there is no risk of an allergic reaction with the next vaccination, and an allergist consultation is not necessary.
What is a severe allergic reaction?
A severe allergic reaction is sometimes called anaphylaxis. Symptoms start very quickly (usually within minutes) and almost always within 4 hours of vaccination and typically include hives; swelling of mouth, lips, tongue or throat; shortness of breath, wheezing, or chest tightness; or low blood pressure or loss of consciousness.
What are the ingredients in the Pfizer-BioNTech COVID-19 Vaccine?
- mRNA.The active ingredient is a nucleoside-modified messenger RNA (modRNA) encoding the viral spike (S) glycoprotein of SARS-CoV-2.
- Inactive ingredients:
- Lipids ((4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate), [(polyethylene glycol [PEG])-2000]-N,N-ditetradecylacetamide, 1,2-distearoyl-sn-glycero-3-phosphocholine, and 0.2 mg cholesterol),
- Electrolytes potassium chloride, monobasic potassium phosphate, sodium chloride, dibasic sodium phosphate dihydrate, and
- Sugar (sucrose)
- The diluent, added to the vaccine for administration, is saline (Sodium Chloride)
What are the ingredients in the Moderna COVID Vaccine?
- messenger ribonucleic acid (mRNA)
- Inactive Ingredients:
- lipids (SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, and 1,2-distearoyl-sn-glycero-3-phosphocholine [DSPC]),
- tromethamine hydrochloride,
- acetic acid,
- sodium acetate,
- Sugar (sucrose)
Which patients should speak to an allergist before receiving the vaccine?
In the vaccine trials, only patients with a history of severe allergic reaction associated with a vaccine and/or severe allergic reaction to any component of the vaccine were excluded. If you are unsure about your vaccine or PEG allergy history, please contact our office to schedule a telemedicine visit with your provider. In general, most patients allergic to one vaccine can receive other vaccinations safely.
What is polyethylene glycol (PEG) and what are common products that contain PEG?
Polyethylene glycol (PEG) is a common, water-soluble ingredient in a wide variety of commercial products including some vaccines and more than 1000 FDA approved medications. It is the primary ingredient in commonly used colonoscopy preparations (Golytely) or constipation treatment (Miralax) as well as in IV medications such as PEGylated medications. It is also in ultrasound gel and injectable steroid injections such as methylprednisolone acetate. Reactions to polyethylene glycol are exceedingly rare but anaphylaxis has been reported.
Please consider the following questions which can help determine your individual risk of allergic reaction to these 2 COVID19 vaccines.
- Do you have a history of a severe allergic reaction to an injectable medication (intravenous, intramuscular, or subcutaneous)?
- Do you have a history of a severe allergic reaction to a prior vaccine?
- Do you have a history of a severe allergic reaction to another allergen (e.g., food, venom, or latex)?
- Do you have a history of a severe allergic reaction to polyethylene glycol (PEG), a polysorbate or polyoxyl 35 castor oil (e.g. paclitaxel) containing injectable or vaccine?
->If the answer is “no” to all four questions, you would be deemed “lower risk” and receive the vaccine under usual conditions with a 15-minute observation period.
->If the answer to question #3 only is “yes,” you are considered “medium risk” and require a 30-minute observation period.
->If the answer to question #1, #2, or #4 is “yes” and you are considering getting a COVID19 vaccine, please contact our office to schedule a telemedicine visit with your provider.
->If you are not sure about the answers to these questions and you are considering getting a COVID19 vaccine, please contact our office to schedule a telemedicine visit with your provider.
1 Banerji A, et al. mRNA Vaccines to Prevent COVID-19 Disease and Reported Allergic Reactions: Current Evidence and Approach, The Journal of Allergy and Clinical Immunology: In Practice (2021)