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The COVID-19 Vaccine: The Latest Information for People With Asthma and Allergies

 
Updates as of March 8, 2021:

  • Added information on the Johnson & Johnson (Janssen) vaccine, ingredients, side effects, and who can get it

As more information becomes available, we will continue to update our community.


The Food and Drug Administration (FDA) has authorized three COVID-19 vaccines for emergency use from Pfizer-BioNTech, Moderna, and Johnson & Johnson (made by Janssen). Other vaccines also are being tested and reviewed.

Following the FDA's decisions, the Center for Disease Control and Prevention (CDC) released updated guidance on who should or should not receive the COVID-19 vaccines.

Information From the CDC on the COVID-19 Vaccines

The CDC released guidelines for the current COVID-19 vaccines. The Pfizer-BioNTech and Moderna COVID-19 vaccines were the first to be authorized by the FDA. They are mRNA-type vaccines. mRNA vaccines teach your immune system to make a protein that starts an immune process. Your body then produces antibodies that can protect you from COVID-19.

The Pfizer-BioNTech vaccine is a shot given in two doses three weeks apart. The Moderna vaccine is also given in two doses about four weeks apart. Based on the clinical trials, you need both doses of these to be fully protected from COVID-19. In the U.S., it is recommended that both doses must come from the same maker. For example, you should not get the Pfizer-BioNTech shot for the first dose and the Moderna shot for the second dose.

The Johnson & Johnson vaccine is only given in one shot. It is a viral vector vaccine. It is different than mRNA vaccines. A viral vector vaccine uses a modified version of a different virus that can’t spread to deliver instructions (in the form of a gene) to cells in your body. This triggers your body to create antibodies to SARS-CoV2, the virus that causes COVID-19. You cannot get COVID-19 from this vaccine since it is a modified virus.

None of the vaccines will affect your DNA. These vaccines reduce the chance of getting COVID-19. They can also reduce the severity of your symptoms if you get the disease.

All three vaccines are very good at protecting you and your loved ones from having severe COVID-19 symptoms, staying in the hospital, or from dying from the virus.

It is not known if the shots prevent the transmission from a vaccinated person to another person. For this reason, even people who had the shot should continue to follow CDC guidelines to reduce spread of the new coronavirus.

  • Wear a face mask
  • Stay home as much as possible
  • Stay 6 feet apart from people outside of your household
  • Wash your hands.

Who Can Get the COVID-19 Vaccine?

In many states, the vaccine is being given in phases. The CDC made recommendations that states may choose to follow, so your state’s roll out may vary. In phase 1a, health care workers and people who live in long-term care facilities can get the vaccine first.

In phase 1b, frontline essential workers (such as first responders) and people 75 or older can get the vaccine.

In phase 1c, people 65 to 74, other essential workers, and people 16 to 64 with other conditions that put them a much higher risk of COVID-19 can get the vaccine.

As the supply grows, everyone will have a chance to get it as part of phase 2.

People age 16 and older can get the Pfizer-BioNTech COVID-19 vaccine. People age 18 or older can get the Moderna or Johnson & Johnson (Janssen) COVID-19 vaccines.

Do not take antihistamine (allergy) medicines (Benadryl, Zyrtec, Claritin) before the vaccine to prevent an allergic reaction. Antihistamines will not keep anaphylaxis from happening and may make it hard to recognize signs and symptoms of a severe reaction. This can delay fast treatment.

Do not take over-the-counter pain medicines like acetaminophen (Tylenol) or ibuprofen (Advil) before getting a COVID-19 vaccine to reduce side effects. Taking the over-the-counter pain medicines or anti-inflammatories may stop the vaccine from working as it should and reduce its ability to make antibodies. It is OK to take pain medicines about 24 hours after you get the shot.

If you get another type of vaccine (like the flu or pneumococcal shots), make sure you wait 14 days before getting the COVID-19 vaccine.

If you get allergy shots (immunotherapy), talk with your allergist if your shot schedule overlaps with getting the COVID-19 shot. There are no data on allergy shots and the COVID-19 vaccine at this time. But to help reduce confusion if you have local reactions or side effects, it may help to spread these out by a couple days.

The following people can get a COVID-19 vaccine:

  • People with medical conditions
  • People who are immunocompromised or immunosuppressed
  • Pregnant and lactating (nursing) people
  • People with allergies to food, pets, insects, venom, pollen, dust, latex, and oral medicines
  • People with a non-serious allergy to other vaccines or injectable medicines
  • People with a family history of anaphylaxis or any other history of anaphylaxis to anything other than a vaccine or injectable medicine

Your doctor may need to give you more information about the vaccine depending on your condition.

If you have a history of severe allergic reactions (anaphylaxis), you may be monitored up to 30 minutes after the shot. For everyone else, you will be monitored for 15 minutes after the shot.

Some people should talk with their doctor about risks and benefits before getting a COVID-19 vaccine. If you do get the vaccine, get the shots in a clinic or doctor’s office:

  • People with a moderate or acute (short-term) illness (such as the flu)
  • People with a history of severe allergic reactions (anaphylaxis) to another vaccine or injectable medicines
  • Anyone who has had a severe or immediate allergic reaction to previous dose or any ingredient (also called “excipients” or “components”) of a COVID-19 vaccine
  • People who have a history of an allergic reaction to PEG or polysorbate

If you have a reaction to the first dose of an mRNA vaccine (Pfizer-BioNTech/Moderna), talk to your doctor about getting the Johnson & Johnson vaccine. You will have to wait 28 days or more to get the Johnson & Johnson vaccine, and you will need to get it from a doctor who is experienced in dealing with allergic reactions, preferably an allergist or immunologist.

People who currently have or recently had COVID-19:

  • Should finish self-isolation and talk to their doctors about when to get the vaccine
  • If you received COVID-19 antibody treatment, you will need to wait 90 days after receiving the treatment to get a COVID-19 vaccine



pfizer covid-19 vaccine chart-v2Click here for larger view

What Ingredients Are in the COVID-19 Vaccines?

The Pfizer-BioNTech and Moderna vaccines do not contain any food proteins, latex, or preservatives. Both contain mRNA (messenger ribonucleic acid).

The Pfizer-BioNTech COVID-19 vaccine contains:

COVID-19-vaccine-ingredients

The Moderna COVID-19 vaccine contains:

Moderna COVID-19 Vaccine Ingredients

The Johnson & Johnson (Janssen) COVID-19 vaccine contains:

Johnson & Johnson vaccine ingredients

What Are the Side Effects of the COVID-19 Vaccines?

Severe adverse reactions to vaccines are very rare. But some mild side effects are normal. This means your body is building your immune system to protect you against the coronavirus.

During clinical trials for the Pfizer-BioNTech COVID-19 vaccine, these were some of the common side effects:

  • Pain and swelling on the arm where the shot was given
  • Fever
  • Chills
  • Fatigue
  • Headache

During clinical trials for the Moderna COVID-19 vaccine, these were some of the common side effects:

  • Pain and swelling on the arm where the shot was given
  • Fever
  • Chills
  • Fatigue
  • Headache
  • Muscle pain
  • Joint pain
  • Swollen lymph nodes in the same arm where the injection was given
  • Nausea
  • Vomiting

During clinical trials for the Johnson & Johnson (Janssen) COVID-19 vaccine, these were some of the common side effects:

  • Pain, redness, and swelling on the arm where the shot was given
  • Fever
  • Nausea
  • Muscle aches
  • Fatigue
  • Headache

More people felt the side effects after the second dose for the mRNA vaccines.

What Do You Do If You Have Side Effects to the COVID-19 Vaccine?

If you have a history of severe allergic reactions (anaphylaxis), you may be monitored up to 30 minutes after the shot. That way, if you have an immediate reaction to the vaccine, you will receive medical help. After you go home, you may experience some of the side effects mentioned above.

For everyone else, you will be monitored for 15 minutes after the shot.

The CDC is asking people to help report any side effects to the COVID-19 vaccines. V-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccination. Through v-safe, you can quickly tell the CDC if you have any side effects after getting the COVID-19 vaccine. Depending on your answers, someone from the CDC may call to check on you and get more information. And v-safe will remind you to get your second COVID-19 vaccine dose if you need one. The information on how to register for v-safe can be found on the vaccination record card you receive when you get the shot. If you cannot find your card, please contact your health care provider.

What Should People With Allergies Know About Allergic Reactions to the COVID-19 Vaccines?

In December 2020, health officials in the United Kingdom issued a very broad warning on the Pfizer-BioNTech vaccine because two people had adverse reactions to the vaccine. Initially they stopped giving the vaccine to people with a history of any severe allergies. But the U.K. Medicines and Healthcare products Regulatory Agency (MHRA) – which is similar to the Food and Drug Administration – later updated their guidelines. The UK recommendations are now similar to the U.S. recommendations and only people with certain allergies should not get the vaccine.

According to Dr. June Raine, MHRA's Chief Executive, “Anaphylaxis is a known, although very rare, side effect with any vaccine. Most people will not get anaphylaxis and the benefits in protecting people against COVID-19 outweigh the risks.”

Only a very small number of allergic reactions – about two to five people per 1 million – to the vaccines have been reported. Most people have not had allergic reactions to the vaccines.

Q&A With AAFA's Medical Scientific Council

Now that the COVID-19 vaccine has reached the U.S., many people with asthma and allergies have questions about it. The Asthma and Allergy Foundation of America (AAFA) talked with three doctors on our Medical Scientific Council on Dec. 10, 2020, about the Pfizer-BioNTech COVID-19 vaccine. Please note this was recorded shortly before the FDA authorized this vaccine.

Here are some of the questions we asked the doctors, and text excerpts from their answers. Please watch the videos below to hear their full answers.

AAFA: When might we expect COVID-19 vaccines (shots) to be available in the U.S.?

Watch on YouTube

Dr. Mitchell Grayson: If you’re talking general population, we’re probably talking late January or February. Probably more March/April. … We really are trying to get those populations most at risk or the health care sector vaccinated first, so it’s going to be a while before [most] people see the vaccine.

Note: This is just an excerpt from the video. Watch the full video clip for the entire answer.



AAFA: What do we know about the clinical trials for the COVID-19 vaccines?

Watch on YouTube

Dr. David Stukus: We don’t know specifically how many people had asthma or food allergies or allergic rhinitis. They didn’t break it down by that when they reported this. There are other categories that are more important in the grand scheme of things to try to figure out whether the vaccine is safe and effective. But they weren’t excluded. The only potential allergy that was excluded specifically were those participants who may have had a severe allergic reaction to prior vaccines or any of the specific ingredients contained in this Pfizer vaccine.

Of note, the Pfizer vaccine does not contain any food proteins, food allergens, or food derivatives. It wasn’t grown in embryos, so there’s no egg or anything like that. We have to assume there were people with some of the more common chronic conditions, especially asthma. We have to assume there were people with asthma, allergic rhinitis, atopic dermatitis, and food allergies enrolled in these trials. We’re not seeing any big scary signals from any group, let alone those.

Note: This is just an excerpt from the video. Watch the full video clip for the entire answer.



AAFA: What does the news in the United Kingdom about adverse reactions to the COVID-19 vaccine mean?

Watch on YouTube

Dr. Stukus: We are caught in this constant news cycle. Everybody’s on red alert and in an effort to get the headlines out. Sometimes we rush to judgement. I would just say to everybody it is OK to take a deep breath. We need context. We need perspective. We need to verify sources. … This is just one of many candidate vaccines. If this one doesn’t pan out for whatever reason, we have more coming.

Dr. Grayson: There’s too much information coming out that is preliminary. I would stress to people to take a deep breath and relax. We’re not going to see the vaccine getting out to the general public for a while. This will be worked through, and we will know who is more at risk then.

Note: This is just an excerpt from the video. Watch the full video clip for the entire answer. Also, more information has come out since this recording and the UK has changed their recommendations (see above).



AAFA: What do people with allergies need to know about vaccine ingredients (which are called excipients or components) and allergic reactions?

Watch on YouTube

Dr. Matthew Greenhawt: The main ingredient I think people are suspicious of is something called polyethylene glycol or PEG. We eat this. It is in a decent amount of food. Orally this doesn’t really cause problems, but injecting it was the one thing that came up and people zeroed in on that.

We have absolutely no causative data. We have absolutely nothing that says this did or didn’t cause it. … I don’t see this as a risk for somebody with food allergy. This could be a general risk for reasons we don’t know and that will emerge. There’s no egg. There’s no peanut.

There are a lot of reasons why people can have a reaction to a vaccine. Some of it can be non-allergic. Just because you had an adverse reaction, that’s the larger umbrella, and allergy is a specific type of an adverse reaction. It happens through a very specific pathway.

Note: This is just an excerpt from the video. Watch the full video clip for the entire answer.



AAFA: What should people with asthma know about the COVID-19 vaccine? Is it a high priority for people with asthma to get the vaccine?

Watch on YouTube

Dr. Stukus: We’ll have to see what the FDA says. … I don’t want people with asthma to think they have to rush out and get it. That being said, asthma is a chronic condition, and if you have other features that place you at high risk based on your age, other chronic health conditions you may have, and the work you do, that is probably going to come into play much more than just the diagnosis of asthma.

Note: This is just an excerpt from the video. Watch the full video clip for the entire answer. This was recorded before the FDA authorized the first two vaccines for COVID-19. Asthma is not a higher risk condition for COVID-19. Check your state's COVID-19 vaccine plan to see when you might be eligible to receive the vaccine.



AAFA: Is there anything else our asthma and allergy community should know so they can make informed decisions?



Watch on YouTube

Dr. Stukus: We have learned so much about allergic conditions. As board-certified allergists and immunologists, we really specialize in, and quite frankly enjoy, the nuances involved. You are each individuals. Just because you have the same diagnosis as somebody else, it may mean completely different management strategies. I think we need to embrace the individualized nature of all of these different chronic conditions. As all of this evolves in regard to the vaccine, that’s what we specialize in. We can find a way to get this done. Hang tight. Things will change. I promise you. As always, talk to your personal allergist. Talk to your personal doctor if you have specific medical questions pertaining to your care, and be careful what you read online.

Dr. Greenhawt: Keep wearing your mask. Keep distancing. Realize this vaccine is designed to stop infection from getting into your body and will do nothing to prevent it from being transmitted elsewhere. ... We are very good at treating reactions or hedging the risks. We’ll get to work on that if this is what needs to be done. We’ve done it before. There’s no reason to deny a vaccine that they want because of an allergic condition.

I think it is very important that everybody who can – and even some of you who don’t want to – gets this vaccine because that’s how you get herd immunity. This is now when we can talk about herd immunity. You give somebody the vaccine. You put the immunity into them, and then the community is protected.

Note: This is just an excerpt from the video. Watch the full video clip for the entire answer.


About our experts

  • Mitchell H. Grayson, MD, Director of the Division of Allergy and Immunology and Professor of Pediatrics at Nationwide Children’s Hospital and The Ohio State University, Chair of the Medical Scientific Council and board member for AAFA
  • Matthew Greenhawt, MD, Director of the Food Challenge and Research Unit at Children’s Hospital Colorado
  • David R. Stukus, MD, Director of the Complex Asthma Clinic and Assistant Professor of Pediatrics in the Division of Allergy and Immunology at Nationwide Children’s Hospital, Ohio



As more information becomes available, we will continue to update our community.

Medical Review March 2021.

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  • COVID-19-vaccine-ingredients
  • Moderna COVID-19 Vaccine Ingredients
  • Johnson & Johnson vaccine ingredients

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