Advice on whether people with a previous allergic reaction can have the AstraZeneca COVID-19 vaccine.

Background

Individuals due to be vaccinated may have had previous allergies, and may also ask their healthcare professional for advice on their suitability for vaccination.

Public Health England’s Immunisation Against Infectious Disease (the Green book) provides further details on the distinguishing features of an anaphylactic reaction compared to other potential reactions.

See also details related to managing anaphylaxis in a vaccination setting.

Below is a summary of knowledge about suitability for vaccination based on previous allergy status.

Allergies and reactions to the first dose of AstraZeneca COVID-19 vaccine

Public Health England’s Immunisation Against Infectious Disease (the Green book) states that the British Society for Allergy and Clinical Immunology (BSACI) advises the following:

  • Individuals with a history of immediate onset-anaphylaxis to multiple classes of drugs or an unexplained anaphylaxis should not be vaccinated with the Pfizer BioNTech vaccine. The AstraZeneca vaccine can be used as an alternative (if not otherwise contraindicated).
  • Individuals with a localised urticarial (itchy) skin reaction (without systemic symptoms) to the first dose of a COVID-19 vaccine should receive the second dose of vaccine with prolonged observation (30 minutes) in a setting with full resuscitation facilities (e.g. a hospital).
  • Individuals with non-allergic reactions (vasovagal episodes, non-urticarial skin reaction or non-specific symptoms) to the first dose of a COVID-19 vaccine can receive the second dose of vaccine in any vaccination setting.

Antibiotics

Public Health England’s Immunisation Against Infectious Disease (the Green book) states that individuals with previous allergy to an identified drug, including anaphylaxis, can receive the AstraZeneca COVID-19 vaccine.

Excipients

The Information for Healthcare Professionals states that a hypersensitivity to any of the excipients is a contraindication to the vaccine use.

For information on the excipients contained in the vaccine and known adverse effects, see Excipients information for AstraZeneca COVID-19 Vaccine.

Food

Public Health England’s Immunisation Against Infectious Disease (the Green book) states that individuals with previous allergy to food, including anaphylaxis, can receive the AstraZeneca COVID-19 vaccine.

For information on the egg, gluten, nut and soy content of the vaccine, see Excipients information for AstraZeneca COVID-19 Vaccine.

Latex

For information on the latex content of the vaccine, see AstraZeneca COVID-19 Vaccine Formulation information.

Other drugs

Public Health England’s Immunisation Against Infectious Disease (the Green book) states that individuals with previous allergy to an identified drug, including anaphylaxis, can receive the AstraZeneca COVID-19 vaccine.

Polyethylene glycol (PEG)

PEG is not present in the AstraZeneca COVID-19 vaccine, according to the Information for Healthcare Professionals.

Public Health England’s Immunisation Against Infectious Disease (the Green Book) advises that the AstraZeneca vaccine is suitable for use in people with a PEG allergy.

“Sulfa” medicines

Public Health England’s Immunisation Against Infectious Disease (the Green book) states that individuals with previous allergy to in an identified drug, including anaphylaxis, can receive the AstraZeneca COVID-19 vaccine.

The Information for Healthcare Professionals does not indicate that any “sulfa” medicines are present in the AstraZeneca COVID 19 vaccine.