Allergic reaction to second COVID-19 vaccine unlikely after reaction to first

Ninety-nine per cent of people who experienced an immediate allergic reaction to their first COVID-19 shot tolerated a second dose without a severe response.

February 24, 2022

New findings support safe second-dose vaccination for individuals who had a severe allergic reaction to their first dose if they’re in a setting with professionals who can manage allergic reactions, says study lead author Derek Chu.

Expert Featured In This Story

Derek Chu
Derek Chu

Assistant Professor

See Profile

People who experienced an immediate allergic reaction to their first COVID-19 vaccine are unlikely to experience a severe immediate allergic reaction to a second dose, says a study involving McMaster scientists.

Researchers from Canada and the United States assessed 22 studies involving 1,366 patients who received second doses of COVID-19 vaccines after experiencing allergic reactions to first doses.

Only 0.16 per cent of patients monitored experienced an immediate severe reaction to a second dose; more than 99 per cent of individuals tolerated their second shot with no immediate severe response.

“These findings show that a history of immediate reaction – including severe immediate allergic reactions – to a prior SARS-CoV-2 mRNA vaccine does not guarantee another reaction to the next vaccine dose,” says Derek Chu, first author of the study and assistant professor of medicine in the division of allergy and immunology.

“Our data support safe vaccination of these individuals in a setting with professionals who can manage allergic reactions.”

Less than 5 per cent of patients who suffered an anaphylactic reaction after a first dose had the same reaction a second time. Overall, 13 per cent of patients developed non-severe, manageable immediate symptoms.

No deaths were reported among individuals throughout the 22 studies analyzed.

The study was published in JAMA Internal Medicine, and builds on work begun in 2021, examining allergic reactions to first doses of COVID-19 vaccines.

“What these results tell us is that, for individuals with concerns regarding allergic reaction, taking a risk with vaccination is better than risking getting COVID-19,” said Matthew Greenhawt, senior author of the study and a professor at the University of Colorado School of Medicine.

“Our job as allergists is to manage risk. Those concerned about an immediate allergic reaction can receive vaccination doses under an allergist’s supervision, especially those worried about a second dose. Full vaccination is important in mitigating infection.”

Angelica McQuarrie, wearing a shirt with the logo for the McMaster Physical Activity Centre of Excellence, in a room full of fitness equipment. In the top left corner is the People of McMaster logo.

Angelica McQuarrie is ‘the steady force’ that keeps PACE going

The program manager at the Physical Activity Centre of Excellence — a place unlike any other — creates a community where everyone feels like they belong.
Two researchers standing side-by-side in a university corridor.

McMaster scientists celebrated for leadership in virology

Miller has received the Grandvaux-McCormick Award for Service to Canadian Virology, and Mossman has been honoured with the CSV’s Mentor Award for Senior Investigators. 
Marcy McCall MacBain, Susan Tighe, Jen Heisz and McMaster students chat with an older adult who is working out in a gym setting.

$50M McCall MacBain Foundation gift propels McMaster’s leadership in helping people live longer in good health

The largest philanthropic gift to kinesiology in Canadian university history supports a long-term vision for global healthspan research, education, health policy and community impact.