March 3, 2021

Millions of doses of lifesaving COVID-19 vaccines have been administered in the United States since December. Still, a quarter of the general public says they probably (or definitely) won't take it due to fears of allergic reactions or side effects.

The NGA sent a letter to Biden on Monday outlining concerns with the COVID-19 vaccine distribution and seeking clarification regarding the allocation process from federal, state and local governments.(AMY OSBORNE/AFP via Getty Images)

Data show that the authorized COVID-19 vaccines are very safe and unlikely to cause an allergic reaction. The rates of allergic reactions to both the Pfizer-BioNTech and Moderna vaccines are low, about 1 in 100,000 or less, with no deaths reported from the vaccine. In contrast, COVID-19 is proven to be deadly for about 1 in 100 people on average. With low risk of allergic reaction and high risk of illness due to COVID-19, we can determine that taking the vaccine is the best action in most cases.

Mild allergic reactions sometimes follow a COVID-19 vaccine; hives and itchiness are the most common symptom and would be treated with an antihistamine such as diphenhydramine (Benadryl).

Severe allergic reactions, called anaphylaxis, are rare with COVID-19 vaccines and can start roughly seven minutes after receiving the vaccine. We think of anaphylaxis as the reaction seen in children with peanut allergies or in people allergic to bee stings. To be considered anaphylaxis, at least two systems of the body need to be involved, usually within minutes of having the vaccine. Most commonly, people have hives or swelling. Reactions can involve the respiratory system (chest tightness, shortness of breath or wheezing), gastrointestinal symptoms (abdominal pain, nausea or vomiting) or cardiovascular symptoms (dizziness, low blood pressure or loss of consciousness). Anaphylaxis is a reaction we prepare for with all vaccinations, and these symptoms can be treated with an injection of epinephrine or adrenaline.

For this reason, the Center for Disease Control and Prevention recommends observation by the team where you get your vaccination for 15 minutes after receiving it, so you can be treated if any reactions occur. If you've had anaphylaxis in the past for any reason, it's recommended you stay for 30 minutes as a precaution.

Your risk of reaction is low, even with a history of common allergies in the past, including:

  • Allergens in air (such as pollen, pets and mold).
  • Food related (peanuts, milk, eggs).
  • Insect stings.
  • Oral medications (sulfa drugs, penicillin, aspirin).

People who have had an allergic reaction to other vaccines, or to any injectable medications, can talk to their allergist or primary care provider about their risk. Reactions to polyethylene glycol (or a related compound polysorbate) are rare. People with this allergy should not receive a COVID-19 vaccine. Consult with your doctor if you're unsure if you've had reactions to polyethylene glycol in the past.

Myths About the COVID-19 Vaccines

Now, you've probably heard some myths about mRNA COVID-19 vaccines (by Pfizer-BioNTech and Moderna), so let's debunk those:

People of color are more likely to have a severe reaction to the vaccine. The small number of reactions that have occurred have not been connected to race or ethnicity. However, allergic reactions may be more common in women than men.

The vaccine has something in it known to cause anaphylaxis. There is an ingredient called polyethylene glycol (PEG) that might cause a reaction. PEG is present in some other medications. If you've had a reaction to any injected medications, talk to your doctor or allergist. These reactions are exceedingly rare: Only 53 have been reported by the Food and Drug Administration.

If I've had a colonoscopy, I shouldn't get the vaccine. The preparation for a colonoscopy does include laxatives with PEG. Unless you had a reaction to that, which is very rare, you should still get a vaccine.

I am allergic to eggs, so I shouldn't get the vaccine. The vaccine does not contain any eggs or egg products.

I am allergic to latex, so I shouldn't get the vaccine. There is no latex in the mRNA COVID-19 vaccines.

No vaccine or medication is perfect. Allergic reactions to the current authorized COVID-19 vaccines are exceedingly low. You're less likely to have a reaction to these vaccines than many commonly used medications and antibiotics like penicillin.