Vaccination against COVID-19 and allergic risk: considerations for use in general practice

ABSTRACT

Context. General practitioners (GPs) work alongside to help provide a COVID-19 vaccination for anyone. They face plenty of questions from concerned patients, such as about vaccine-related anaphylaxis. Objective. To provide an up-to-date overview to help GPs answer questions about a COVID-19 vaccination in case of history of allergies. Methods. A narrative literature review was performed until January 21, 2021. Data were collected from French and international authorities guidance and the main international scientific societies of Allergy. The guidelines for the management of anaphylaxis were added a posteriori. Results. Anaphylactic reactions related to the mRNA COVID-19 vaccine are very rare. A history of allergic reactions or anaphylaxis is generally not a contraindication to the vaccination, except in case of a systemic reaction to the 1st dose of the vaccine or a previous reaction to any of its components. These are absolute ones. People with a local reaction to the 1st dose can receive the 2nd dose. Conclusion. The up-to-date collected data are reassuring the rate of anaphylaxis related to the mRNA COVID-19 vaccine is similar to other vaccines. People with history of allergies, including anaphylaxis (except for the COVID-19 vaccine or its components), can receive the vaccine. The benefit of the vaccination in case of history of allergies outweighs the risk. These data will allow GPs and their patients to make an enlightened and more rational choice in the shared decision-making process.