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Allergic Reactions to COVID Vaccines

Medically reviewed by Bari Cunningham, MD, Susan Kerrigan, MD and Marianne Madsen on January 13, 2023

The development of a vaccine to prevent COVID-19 is a modern miracle. As SARS-CoV-2 (the virus that causes COVID-19) raged across the planet, leaders championed vaccination as the best way to end its spread. In the United States, multiple vaccines became available, as early as December 2020. The goal of these vaccines was to decrease the severity of COVID-19 infection and possibly help prevent disease spread. According to the Lancet journal “Since their development and distribution, it is estimated that vaccinations prevented 14.4 million deaths from COVID-19 in 185 countries and territories between Dec 8, 2020 and Dec 8, 2021” 

 

The development of the COVID-19 vaccines was at an astonishingly fast pace. “It’s absolutely astonishing that this has happened in such a short time—to me, it’s equivalent to putting a person on the moon,” pediatric infectious-disease specialist Cody Meissner at Tufts University School of Medicine and Tufts Children’s Hospital in Boston, Massachusetts told Nature. “This is going to change vaccinology forever.” The technology for the mRNA vaccines, distributed in the US (Pfizer and Moderna), had already been developed in prior years but had not yet been utilized for this type of virus. That technology was able to be quickly adapted to address the COVID-19 virus and the novel therapies became available quickly. 

 

Becoming a world leader in vaccinations meant the U.S. was no longer a world leader in COVID-19 fatalities as the virus’s worst impacts spread south to countries including Brazil and Peru. Still, true herd immunity may be a long way off. Yes, millions of infected survivors likely have some resistance to the virus––and are more likely to be amongst the young who are least likely to take the vaccine. Still, in the U.S. and many developed countries, there are pockets of populations where far less than half are vaccinated. There are many reasons for hesitancy, but a big one is being scared of allergic reactions to COVID vaccines. So what are the known reactions and how do these differ from side effects?

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COVID mRNA Vaccine Explained

COVID mRNA Vaccine Explained

Fast Development

 

Being concerned is normal. The vaccine was developed very quickly. It’s natural to wonder if corners were cut or unacceptable risks accepted. Yet when it comes to the development of the COVID-19 vaccine, much of the speed has more to do with money than testing. 

 

The COVID-19 vaccine’s development was fast because of unprecedented funding levels and scientific involvement. Although it took years after the first SARS pandemic before the SARS-CoV-2 structure was mapped, this information was published online just weeks after it was first identified. Quickly, scientists across the world were working on an mRNA vaccine. Unlike earlier vaccines that use a weakened virus, these new vaccines don’t use a virus at all. Instead, they trigger your body’s immune response by “looking like” the coronavirus. In general, an mRNA vaccine teaches our cells how to make a protein or part of a protein. This motivates an antibody-producing immune response. 

 

With the sequencing and vaccine development structure already in place, an eight-month process was trimmed to five. Then, by using larger groups of volunteers in Phase III trials and funding multiple vaccines, a 42-month process was trimmed to just six. Although granted Emergency Use under the FDA, the two main vaccines (Pfizer–BioNTech and Moderna) had data and studies to back them up. These vaccines, along with those by Oxford AstraZeneca and J&J/Janssen, have now been used over one billion times across the planet. 

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COVID-19 Vaccine

COVID-19 Vaccine

Side Effects vs Allergies

 

COVID-19 vaccines, like other vaccines, are aimed to mount an immunological response inside your body. Side effects that can be expected, and are NOT considered an allergy, include:

 

  • Injection site reactions of redness, swelling, pain
  • Fatigue
  • Headache
  • Muscle aches
  • Fever
  • Chills
  • Nausea
  • Vomiting
  • Enlarged lymph nodes (especially near the armpit on the side of the vaccination)
  • Dizziness
  • Swelling in the face (especially in those with dermal fillers) 

 

True allergic reactions to the COVID-19 vaccines are rare and occur at a rate of approximately one event per million administrations. These reactions often occur in the first 15-30 minutes of getting vaccinated. For this reason, sites across the world ask that people wait around after getting their shot. While the vaccine is training our immune system, in some people it overreacts and allergic antibodies called immunoglobulin E (IgE) cause an immediate reaction which can include anaphylaxis. In those who have reacted to the vaccine, common symptoms include difficulty breathing, confusion, blue lips, and even loss of consciousness. It is still unclear if these reactions are all true IgE mediated anaphylactic reactions. These reactions, however,  have been linked to the inactive ingredients in the vaccine. The U.S. Centers for  Disease Control and Prevention has cautioned those with an allergy to PEG (an ingredient in the mRNA vaccines) and polysorbate (an ingredient in the J&J/Janssen vaccine) should avoid those vaccines. However, if you have other allergies––even to food or medication––the vaccine is still recommended. 

 

Besides allergic reactions,  adverse drug reactions including blood clots, heart inflammation (myocarditis), and Bell’s palsy have been reported in a very small number of cases. Those patients may be advised against future vaccination with the same type of vaccine. Some patients may develop swelling or hives weeks after the injection. These are thought to be triggered by the immune stimulation of the vaccine and do not require someone to avoid repeat vaccination in the future. Overall, the COVID-19 vaccines are thought to have a similar safety profile as other routine vaccines and have shown to decrease deaths and severity of disease from the COVID-19 viruses. Newer strains have been developed and will likely continue to be offered to address changing strains across the globe.

 

Written by John Bankston

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