Dr. Mary Hanna saw an increase in requests for allergy assessments at her Burlington, Ontario, clinic, when the province began implementing COVID-19 vaccine certifications last month.

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Whether people have held off on getting vaccinated because of a previous reaction, or are seeking a waiver of vaccination mandates, Hanna said a past allergic reaction doesn’t mean you can’t get your shots.

He said allergists across the country safely vaccinate most patients coming to their clinics, regardless of allergy history.

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“Whether it’s an excuse or a misunderstanding or some miscommunication there, we’re definitely getting a lot of referrals because of[vaccine regulations],” said Hanna, assistant clinical professor at McMaster University.

“Most of the time, it doesn’t lead to remission.”

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Hanna said many of the patients she evaluates are concerned about past reactions to non-COVID-19 vaccines.

But because the mRNA jabs of Pfizer-BioNtech and Moderna are different from typical inoculations, those previous reactions usually do not recur.

Others are concerned about patients receiving a second mRNA dose if they have had an adverse reaction to the first. But she said many patients mistake common non-life-threatening reactions — including a rash or swelling at the injection site — for allergies.

“It’s only very, very few patients who have had a systemic reaction, usually within 15 to 20 minutes of receiving the first dose, that we want to be careful about,” Hannah said. “Most of the side effects we expect from a vaccine are not contraindications to remission.

“And sometimes you just need an allergy to help clear it up.”

Allergists assess patients in their specialized clinics, taking a complete history to determine the severity of the previous allergy experience — and whether it was an allergic reaction.

Evaluations can sometimes include skin tests, where a component of the vaccine is smeared on a small patch of skin, but Hanna said each patient’s appointment will be different.

Dr Samira Jamie, a clinical immunology and allergy specialist at Western University, said even those who experienced strong allergic reactions could be mistaken.

Some non-allergic reactions can include anxiety-related events that mimic allergic reactions, she said, hyperventilation, fainting and even symptoms that look and feel like anaphylaxis — a severe, A potentially life-threatening reaction where the blood pressure drops and the airway narrows, making breathing difficult.

“Things that mimic anaphylaxis are far more common than actual anaphylaxis,” Jamie said. “An example is vocal cord dysfunction, where one can actually turn off their vocal cords[when]panicked.”

The Canadian Society of Allergy and Clinical Immunology states that the risk of systemic allergic reactions, including anaphylaxis, is extremely rare. Studies suggest that the estimated annual rate of anaphylaxis in Canada is approximately 0.4 to 1.8 cases per million vaccine doses.

According to a Health Canada review on adverse vaccine reactions, there have been 307 cases of anaphylaxis in the country — more than 56 million COVID-19 doses administered.

Jamie said his London, Ont., clinic is able to vaccinate “about 99 percent” of people who come in with allergy concerns. This includes people who have had a real, severe reaction to the first COVID-19 vaccine dose.

Allergies work around this by giving a small amount of the dose to someone with a confirmed allergy, separated by a 15- to 30-minute observation period, until the dose is reached.

Jamie said a graded administration for extreme cases could take hours to complete.

“If I think the patient is at moderate risk of a reaction, I will split the vaccine into three or four doses,” she said. “If the patient is at higher risk, I’ll take the dose even longer.”

Canada’s National Advisory Committee on Immunization says COVID-19 vaccines should not be given “routinely” to people who had severe allergies after the first dose.

If a risk assessment considers the benefits of vaccination to outweigh the risks of allergies, the NACI states that the reason for the initial reaction is to use a different vaccine – either AstraZeneca’s viral vector jab or mRNA products – to complete the two-dose series. to be done.

Jamie said his clinic has AstraZeneca supplements for emergency situations, but he hasn’t had to use them. Instead, most people can safely complete a two-dose mRNA chain.

Jamie said allergists are not sure which component of mRNA vaccines causes severe allergies in a small number of people. But PEG, or polyethylene glycol, “is currently believed to be the culprit.” He added that PEG allergy on skin tests is not necessarily “related to vaccine tolerance,” however.

Jamie said PEG is a common ingredient in cosmetics, skin care products, and some medications, including Tylenol and cough syrups. So people with a PEG allergy know they have it before receiving the mRNA vaccine.

The NACI says a COVID-19 vaccine “should not routinely be given to individuals who are allergic to any component of the jab”.

Jeimy urges people to seek clarification from a doctor before taking the oath of COVID-19 shots.

“I don’t think it’s helpful to avoid things in advance because of fear of a reaction,” she said. “You are at far greater risk of COVID-19 infection.”

This report by The Canadian Press was first published in the Sun. October 17, 2021.