Coronavirus (COVID-19) Update
We're open! Patient safety remains our top priority as we re-open our office. Check out our updated COVID-19 policies before your next visit. Dr. Mehta is also providing telemedicine visits for patients that request them.

Get Clarity on COVID-19

Allergic Reactions to COVID-19 Vaccine Explained

Dr. Reena Mehta is a board-certified immunologist in New Orleans, LA that can help you navigate COVID-19 vaccination and any health concerns that you have.

We’ve re-opened our office in Uptown New Orleans. Please review our new safety policies before your next visit. Dr. Mehta is also providing telemedicine visits to answer your questions about COVID-19 and help you through any health concerns that you might have during this uncertain time. If you have a fever and lower respiratory symptoms (cough, chest congestion, or shortness of breath), Dr. Mehta can provide rapid screening for you in a brief telemedicine visit, and help you determine if you should be tested for coronavirus.

We are welcoming new and existing patients. If you’re an existing patient of Dr. Mehta and are scheduled for an upcoming visit, please review our new COVID-19 policies below. In accordance with CDC guidelines, we are practicing social distancing to the best of our ability. The current situation continues to change, and we will continue to update our policies as we learn more. We greatly appreciate your flexibility, and helping us keep New Orleans healthy.

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COVID-19 Vaccination Allergy Specialist Dr. Reena Mehta in New Orleans, LA
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COVID-19 Vaccination Guidelines for Individuals with Allergies

In the United States, there are currently two commercially available COVID-19 mRNA vaccines which are manufactured by Moderna and Pfizer-BioNTech. Below is a summary of CDC and AAAAI guidelines on who should and should not receive a COVID-19 mRNA vaccine, especially when an individual has a personal or family history of allergic reactions.

Patients who are not at increased risk for severe allergic reaction are monitored for at least 15 minutes after getting the COVID-19 vaccine before they are discharged. For those who do experience a severe allergic reaction following administration of either vaccine, lab testing can be done to further assess and verify if anaphylaxis occurred after COVID-19 vaccination.

Neither the Pfizer-BioNTech nor the Moderna COVID-19 vaccine contain preservatives, eggs, or gelatin. If you have a personal or family history of allergic reaction to food, you are okay to get COVID-19 vaccinated.

The mRNA vaccines are packaged in vials with stoppers that are not made of natural rubber latex, so there is no contraindication to vaccination or extra precaution for individuals with a history of latex allergy.

People with a personal or family history of allergic reaction to pets, insect venom, other environmental allergens, or oral medications can also get COVID-19 vaccinated.

Common Side Effects of COVID-19 Vaccination

It is normal to experience some unpleasant side effects after receiving a dose of a COVID-19 mRNA vaccine. These side effects are not necessarily indicative of an allergic reaction and should go away in a few days. Common side effects include:

• Pain at the site of injection
• Swelling at the site of injection
• Fever
• Chills
• Fatigue
• Headache

Allergic Reactions to COVID-19 Vaccination

Severe Allergic Reaction to a COVID-19 mRNA Vaccine Ingredient or a Prior Vaccine Dose

Any reaction requiring epinephrine treatment or hospitalization is considered a severe allergic reaction. Anaphylaxis after getting a COVID-19 vaccine is considered a severe allergic reaction. If you had a severe allergic reaction after getting the first dose of an mRNA COVID-19 vaccine, CDC recommends that you should not get the second dose. In addition, if you have ever had a severe allergic reaction to any ingredient in an mRNA COVID-19 vaccine, you should not get either of the currently available mRNA COVID-19 vaccines.

For the Pfizer-BioNTech mRNA COVID-19 vaccine, the list of ingredients is below:

• Nucleoside-modified mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2
• 2[(polyethylene glycol)-2000]-N,N-ditetradecylacetamide
• 1,2-distearoyl-sn-glycero-3-phosphocholine
• Cholesterol
• (4-hydroxybutyl)azanediyl)bis(hexane-6,1-diyl)bis(2-hexyldecanoate)
• Potassium chloride
• Monobasic potassium phosphate
• Sodium chloride
• Dibasic sodium phosphate dihydrate
• Sucrose

For the Moderna vaccine, the list of ingredients is below:

• Nucleoside-modified mRNA encoding the viral spike (S) glycoprotein of SARS-CoV-2
• PEG2000-DMG: 1,2-dimyristoyl-rac-glycerol, methoxypolyethylene glycol
• 1,2-distearoyl-sn-glycero-3-phosphocholine
• Cholesterol
• SM-102: heptadecan-9-yl 8-((2-hydroxyethyl) (6-oxo-6-(undecyloxy) hexyl) amino) octanoate
• Tromethamine
• Tromethamine hydrochloride
• Acetic Acid
• Sodium Acetate
• Sucrose

Any reaction requiring epinephrine treatment or hospitalization is considered a severe allergic reaction. Anaphylaxis after getting a COVID-19 vaccine is considered a severe allergic reaction. If you had a severe allergic reaction after getting the first dose of an mRNA COVID-19 vaccine, CDC recommends that you should not get the second dose. In addition, if you have ever had a severe allergic reaction to any ingredient in an mRNA COVID-19 vaccine, you should not get either of the currently available mRNA COVID-19 vaccines.

Non-Severe Allergic Reaction to mRNA COVID-19 Vaccine Ingredients

Both commercially available COVID-19 mRNA vaccines contain ingredients that may cause allergic reactions in some individuals. If you have ever had an immediate allergic reaction to a component found in the COVID-19 mRNA vaccine (i.e. hives or swelling within 4 hours of exposure), even if it was not severe, the CDC recommends that you do not get vaccinated with either the Pfizer-BioNTech or Moderna vaccines.

For example, Polyethylene Glycol (PEG) is an ingredient in both mRNA vaccines. If you are allergic to PEG, you should not get an mRNA COVID-19 vaccine. Closely related to PEG is polysorbate. If you are allergic to polysorbate, the CDC recommends that you should not get an mRNA COVID-19 vaccine.

Non-Severe Allergic Reaction to a Previous Dose of an mRNA COVID-19 Vaccine

If you previously received a dose of an mRNA COVID-19 vaccine and you had a non severe but immediate allergic reaction, you should not get the second dose of the vaccine.

Anaphylaxis After COVID-19 mRNA Vaccine Administration

Based on reports from the CDC, only a few cases of anaphylaxis have been reported through the Vaccine Adverse Event Report System. From December 21, 2020 to January 10, 2021, 10 cases of anaphylaxis out of a reported 4,041,396 first doses of Moderna COVID-19 vaccine were detected. This equates to 2.5 cases of anaphylaxis per million doses administered.

During the rollout of Pfizer-BioNTech’s COVID-19 vaccine from December 14, 2020 to December 23, 2020, 21 cases of anaphylaxis occurred after administration of a reported 1,893,360 first doses of the Pfizer-BioNTech COVID-19 vaccine. This equates to 11.1 cases of analyphysis per million doses.

No anaphylaxis-related deaths were reported for either vaccine. Most cases of anaphylaxis occurred within 15 minutes of vaccination.

Talking to Your Allergist About COVID-19 Vaccination

Ask your allergist if you should get a COVID-19 mRNA vaccine if you have a history of anaphylaxis. Also consult an allergist about getting vaccinated if you have had a history of non severe but immediate allergic reaction to other vaccines or injectable therapies.

Some medications, such as daily oral steroids, may interfere with the antibody response to the COVID-19 vaccine. Talk to your doctor about any potential drug interactions with the COVID-19 vaccine.

If your healthcare provider determines that the benefit of getting COVID-19 vaccinated outweighs the risks, you are recommended to receive the vaccine. You will be monitored for at least 30 minutes after vaccination, given your increased risk for allergic reaction. Vaccination providers will have equipment and medication ready in the event of anaphylaxis.

COVID-19 Vaccine Allergy Testing

Uptown Allergy & Asthma is not offering COVID-19 vaccine allergy testing at this time. However, testing protocols do exist. In the US, there are currently two commercially available blood tests that healthcare professionals can order to help assess a severe allergic reaction, such as anaphylaxis, following COVID-19 vaccination. However, these lab tests cannot definitively diagnose the cause of a severe allergic reaction.

The two commercially available lab tests are:

• Tryptase
• SC5b-9

Blood samples for these lab tests should only be collected once a patient is medically stabilized. Ideally, blood samples should be collected between 30 and 90 minutes after the start of the allergic reaction, when certain markers are still elevated. Blood samples may still be helpful even if collected up to 6 hours after a reaction.

Tryptase

Tryptase is an enzyme that is released, along with histamine and other chemicals, when mast cells are activated during an allergic response. Normally, tryptase levels in the blood are very low, but they can rise rapidly when mast cells are activated. Tryptase levels will be very high in people with anaphylaxis. In some cases, tryptase levels will be high in individuals with mast cell activation disorders, where mast cells activate without a clear reason.

SC5b-9

Soluble Complement 5b-9 (sC5b-9) forms on the surfaces of targeted cells and disrupts cell membranes, causing cell lysis and death. Elevated sC5b-9 levels indicate increased activation of the alternative complement pathway, which is one of the pathways initiated during an immune response. After a severe allergic reaction, sC5b-9 levels are transiently elevated.
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Get Clarity on COVID-19 in New Orleans

Dr. Mehta is providing telemedicine visits to answer your questions about COVID-19, allergies, and asthma and help you through any health concerns that you might have during this uncertain time. Dr. Mehta has a reputation for developing strong relationships with her patients and being exceptionally attentive to their needs and concerns.

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2622 Jena St,
New Orleans, LA 70115

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