Risk of Second Allergic Reaction to SARS-CoV-2 Vaccines

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Abstract
SARS-CoV-2 vaccination effectively reduces the risk of infection and severe COVID-19 outcomes. With more than 8.6 billion doses administered worldwide, immunization is a global priority to stem the count of the approximately 274 million infected and 5.3 million dead.1 Factors associated with facilitating vaccination include increasing vaccine mandates and supply, whereas factors associated with barriers to vaccination include vaccine inequity, hesitancy, disinformation and misinformation, and rare adverse effects, such as severe allergic reactions (which occur in 7.9 per 1 million vaccinations2). Early in the global vaccine rollout, December 9, 2020,3 rare cases of allergic reactions to mRNA vaccines rapidly led to recommendations stating that persons with an immediate allergic reaction to the first dose of an mRNA COVID-19 vaccine should not receive additional doses of either of the mRNA COVID-19 vaccines.3-5 This contraindication is inconsistent with allergy specialist practice parameters, which do not contraindicate readministration of non-COVID vaccines to those with prior vaccine allergic reactions.6

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