Specialist allergy advice allows vaccination in patients with reactions to COVID-19 vaccines.

Vaccination remains the most effective means out of the COVID-19 pandemic. Data from randomised clinical trials demonstrated that COVID-19 vaccines, reduce severe COVID infections and prevent deaths1 . However, there was initially an unexpectedly high rate of suspected allergic reactions to COVID-19 vaccines (for anaphylaxis 2.5-11.1 cases/million doses for the mRNA vaccines) compared with non-COVID-19 vaccines (1.3 cases/million doses) which caused considerable alarm,2,3 , placing significant pressure on allergy centres. It also perpetuated fears circulating in the media about COVID-19 vaccines resulting in vaccine scepticism and hesitancy. Allergic reactions following vaccination may be due to any of the excipients (adjuvants, preservatives, emulsifiers, stabilizers etc.) 3 . Polyethylene glycol (PEG) in mRNA COVID-19 vaccines (Pfizer-BioNTech, Moderna) remains the only likely IgE mediated allergenic suspect, but investigation has so far confirmed this in only one case4 .