[Alternate text] Dear Reader, In the span of just a few minutes, your throat, tongue, and mouth suddenly swell to the point that breathing is difficult. face may balloon so much that itâs hard to open your eyes. You may suffer stomach cramps and a racing heart. Your blood pressure may crash. In the worst cases, patients lose consciousness and die if they donât get prompt medical care. A severe allergic reaction is terrible, life-threatening experience. This kind of allergic responseâalso known as anaphylaxisâis the most disturbing side effect of the two coronavirus vaccines now available. The latest report from the Centers for Disease Control and Prevention shows that there have been 45 confirmed cases of severe allergic reactions to the Pfizer vaccine and 15 to the Moderna shots. That works out to a rate of 6.2 cases per million doses for the Pfizer shot and 2.1 for the Moderna vaccine. Thatâs rareâalmost like winning the lottery. But itâs a lottery nobody wants to win. Hereâs what you can do to help make sure that youâre not one of the unlucky ones⦠Vaccine Anaphylaxis: Take This Test to Gauge Your Risk Researchers at Massachusetts General Hospital recently did an extensive review of severe allergic reactions in people getting vaccines. They devised a simple four-question test to determine a personâs risk, along with recommendations based on the answers. The scientists published their findings in The Journal of Allergy and Clinical Immunology. Here are the four questions: - Do you have a history of a severe allergic reaction to an injectable medication?
- Do you have a history of a severe allergic reaction to a prior vaccine?
- Do you have a history of a severe allergic reaction to another allergen like food, bee stings, or latex?
- Do you have a history of an immediate or severe allergic reaction to PEG, polysorbate, or polyoxyl 35 castor oil? If you answered no to all the questions, you are at low risk. But the researchers advise that you be observed for 15 minutes after being vaccinated just to make sure. If you answered yes to questions 1, 2, or 3, you are at medium risk. You should be observed for 30 minutes after being vaccinated. If you answered yes to question 4, you are at high risk. The researchers advise that you get allergic skin test before getting vaccinated. Question 4 is important because PEG (polyethylene glycol) is used in both the Pfizer and Moderna vaccines. It is widely suspected as the culprit in the anaphylaxis cases. Polysorbate and polyoxyl 35 castor oil are chemically related to PEG. So if you are allergic to them, you will likely be allergic to PEG. PEG is a fat. It helps carry the active ingredient in the vaccines, mRNA, into our cells, where it can generate an immune response against the coronavirus. PEG is widely used in medicines, cosmetics, and processed foods. It was once thought to be harmless. But there is growing evidence that this is not true. A 2018 journal article titled Can You Really Be Allergic to an âInactive Ingredient?â documents cases of severe PEG allergic reactions. Most patients suffered anaphylaxis after taking laxatives containing PEG prior to getting a colonoscopy. âSuch reactions my currently be under-recognized,â the authors noted. A PEG allergy can be diagnosed with a skin test. A personâs skin is pricked with a diluted PEG solution. If an allergic reaction occursâswelling and redness around the skin prickâthe person should not get a vaccine with PEG. If the skin prick caused no reaction, another test is given to confirm the results. A shallow injection of PEG is given just under the skin. If no reaction occurs, the person should be able to get vaccinated without worry. If they do react, they should not get vaccinated. Ideally, the vaccines themselves should be used in the allergy tests, the Massachusetts General researchers said. But they are in such short supply that they donât recommend it. Weâre still in the early days of the vaccine roll out. But so far, anaphylaxis appears to be the most disturbing side effect of the shots. So far, no one has died from it. All patients were treated with epinephrine (EpiPens), which stops the allergic response. But several had to be put on ventilators so they could breathe. Even though itâs rare, you should do all you can to make sure that you donât go through this ordeal. After answering the questions above, be sure to consult your doctor if you think you could be allergic to the coronavirus vaccine. In Good Health, Amanda Angelini
Director
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