Kids/adults with nut allergies and Covid vaccine

[crazyforlatin]

We don’t meet with the allergist until next month to refill an epipen prescription. And Dd doesn’t qualify for the vaccine until a few months later, and with the way things are here, she may not even be able to get it until Fall.

Has anyone asked their allergists? Is there anything for us to consider? Should we choose one vaccine over the other? Will the immune response react differently to a Covid vaccine because hers respond differently to nuts and certain spices? She’s not had any bad reactions to other vaccines or flu shots. But the allergic reactions from one of the vaccines has me a bit worried.

 

ETA: if adults with food allergies requiring epipen have gotten the vaccines, could you tell me which vaccine and what reactions you had?

ETA: And if your child has allergies, are you holding off until there’s more confidence/data that your child won’t react to the vaccine? 

Edited March 28, 2021 by crazyforlatin

[Spryte]

We have two kids with LTFAs.  One is peanuts, all tree nuts, sesame, avocado, lentil, banana, latex for anaphylaxis.  Wheat, dairy, egg for less severe history.  Other kid is dairy - cow, goat, sheep (all anaphylaxis).  I am shellfish and a few things, and my mom is tree nuts.  (Try cooking at our house! Ha!)

We met with the allergist and she encouraged us to get any of the shots we can get.  Take the epipens and inhalers, stay 30 mins after.  The main ingredient causing reactions seems to be propylene glycol.  Like in Miralax.  

[Spryte]

Oh!  I forgot to say DS had his first Pfizer shot ten days ago, no problem!

It’s stressful, isn’t it?

[crazyforlatin]

1 minute ago, Spryte said:

We have two kids with LTFAs.  One is peanuts, all tree nuts, sesame, avocado, lentil, banana, latex for anaphylaxis.  Wheat, dairy, egg for less severe history.  Other kid is dairy - cow, goat, sheep (all anaphylaxis).  I am shellfish and a few things, and my mom is tree nuts.  (Try cooking at our house! Ha!)

We met with the allergist and she encouraged us to get any of the shots we can get.  Take the epipens and inhalers, stay 30 mins after.  The main ingredient causing reactions seems to be propylene glycol.  Like in Miralax.  

Thanks so much! Just need to read this from parents with similar kids. We don’t know anyone else with severe allergies IRL.

[Ottakee]

My dd with severe reactions to shellfish and mild to coconut had the Pfizer and did very well   she had no reaction to the first dose and just a mild stomach reaction to the second dose.  She carried her epi pen and higher risk people waiting 30 minutes.  

[Spryte]

1 minute ago, crazyforlatin said:

Thanks so much! Just need to read this from parents with similar kids. We don’t know anyone else with severe allergies IRL.

Totally understand!  I don’t usually list all our allergies out, but wanted you to know we really take them seriously.  It helps me to talk to other parents, too.  

[crazyforlatin]

Just now, Spryte said:

Oh!  I forgot to say DS had his first Pfizer shot ten days ago, no problem!

It’s stressful, isn’t it?

Yes it’s been on my mind for a year, not knowing if catching the virus would be more difficult for an allergic kid to fight off and then not knowing if Dd can safely get the vaccine. We’re also surrounded by anti-Covid virus and vaccine.  

I’m happy for your DS! It’s very encouraging to hear this.

[crazyforlatin]

1 minute ago, Ottakee said:

My dd with severe reactions to shellfish and mild to coconut had the Pfizer and did very well   she had no reaction to the first dose and just a mild stomach reaction to the second dose.  She carried her epi pen and higher risk people waiting 30 minutes.  

Thank you for sharing this! It’s a relief to read this, should have asked this question sooner rather than stressing over this on my own.

[crazyforlatin]

2 minutes ago, Spryte said:

Totally understand!  I don’t usually list all our allergies out, but wanted you to know we really take them seriously.  It helps me to talk to other parents, too.  

Well, it’s awkward for us to order take out and tell people Dd has ginger allergy (and cardamon, they are apparently related to each other) at Asian restaurants. 

[Spryte]

3 minutes ago, crazyforlatin said:

Well, it’s awkward for us to order take out and tell people Dd has ginger allergy (and cardamon, they are apparently related to each other) at Asian restaurants. 

Those sound like difficult ones!  The ones not in the top 8 are such a pain in the neck!

[Farrar]

I've known a number of people who have histories of anaphylaxis who have had it now. All of them were advised to get it despite that history. All had to wait longer post-shot - 30 minutes instead of 15. None had any reactions of the allergy kind (the normal fluish reactions, pain in the arm, etc., but not allergy reactions). The reactions are just incredibly rare. Obviously you should seek the advice of the allergist, but unless it's something super specific and unusual, I think the advice is going to be to get it and be sure to disclose and stay the extra time in the monitoring area. 

Edited March 28, 2021 by Farrar

[Katy]

I know two people with shellfish allergies and another with probably a dozen food allergies. All did fine. 

[wathe]

One of my family members has LTFA.  His allergist recommends vaccination without hesitation.  We will get him vaccinated as soon as he is eligible.

From the Canadian Society of Allergy and Clinical Immunology Statement (didn't format very well with copy-paste):

The CSACI would like to reassure our fellow Canadians that unless one has a pre-existing allergy to a component of a vaccine, including the Pfizer/BioNTech COVID-19 vaccine, it is safe to proceed with vaccination for COVID-19.In addition, those with otherallergic problemsare no more likely to experiencean allergic reaction to the COVID-19vaccine than the general population andshouldsafely be able to receive this vaccine—this includesthose with a history of serious allergic reactionsor anaphylaxisto substances that are not an ingredientinthis vaccine, and those with food allergy, eczema, allergic rhinitis (hayfever), asthma, or stinging insect allergy.

 

[sbgrace]

Just adding another voice. My husband has anaphylactic food allergies. He didn't tell them because they only asked about drug or vaccine allergies when checking him in, so he wasn't told to stay longer (though he did). He had epi pens. No problems--Pfizer. 

I am signing my son up (Pfizer, he's under 18) as soon as he is eligible next week. He is anaphylactic to tree nut, sesame , and mango. His allergist/pulmonologist definitely recommended he get the shot when we had our last appointment. He'll have an epi pen and wait 30 minutes, but I don't expect problems. 

[redheadmom]

So my dd has both a bee venom allergy and alpha-gal (the tick borne allergy to mammal meat).  Both of these can cause anaphylaxis. She has to be very careful with animal byproducts such as gelatin, glycerin, etc.  She got the Pfizer vaccine a week ago and did good.  She stayed there for 30 ninutes after the shot and then we watched her for the 8-12 hour window for alpha gal reaction.  She did take her normal antihistamines the day of her shot. 

[TravelingChris]

Both dd2 and I had Pfizer shots 1 this week.  I have an allergy to limes and dragon fruit, neither anaphylactic but I  am anaphylactic to several medications.  I didn't have any side effects at all.  My dd2 is anaphylactic to all citrus and she felt a bit blah.

[crazyforlatin]

Thank you for the additional feedback! These posts really help us.

[Lulu]

My nephew has allergies to tree nuts, peanuts, bees, shell fish, he also has celiac. He got the moderna vaccine, he had an anaphylactic reaction about 20 mins after the shot. They took him to the hospital and had to give him another epi shot. He was released the next day.

[wathe]

2 hours ago, Spryte said:

We have two kids with LTFAs.  One is peanuts, all tree nuts, sesame, avocado, lentil, banana, latex for anaphylaxis.  Wheat, dairy, egg for less severe history.  Other kid is dairy - cow, goat, sheep (all anaphylaxis).  I am shellfish and a few things, and my mom is tree nuts.  (Try cooking at our house! Ha!)

We met with the allergist and she encouraged us to get any of the shots we can get.  Take the epipens and inhalers, stay 30 mins after.  The main ingredient causing reactions seems to be propylene glycol.  Like in Miralax.  

Yes, polyethylene glycol.  It's a super common ingredient in laxatives, cosmetics, and common medications including Zyrtec and some formulations of Tylenol. 

[crazyforlatin]

2 minutes ago, Lulu said:

My nephew has allergies to tree nuts, peanuts, bees, shell fish, he also has celiac. He got the moderna vaccine, he had an anaphylactic reaction about 20 mins after the shot. They took him to the hospital and had to give him another epi shot. He was released the next day.

That’s really scary, does that mean he will not be able to get the second shot due to the reaction?

[crazyforlatin]

Just now, wathe said:

Yes, polyethylene glycol.  It's a super common ingredient in laxatives, cosmetics, and common medications including Zyrtec and some formulations of Tylenol. 

Do you happen to know if polyethylene glycol is in other vaccines? Obviously we never did a skin test on this. 

[PeterPan]

3 minutes ago, crazyforlatin said:

Do you happen to know if polyethylene glycol is in other vaccines? Obviously we never did a skin test on this. 

You can google to check ingredients. I was just on the CDC site and they have snazzy pages for each vaccine. Looks like the polyethelyne glycol is in the Pfizer and Modern but not the J/J. 

[SDMomof3]

19 minutes ago, Lulu said:

My nephew has allergies to tree nuts, peanuts, bees, shell fish, he also has celiac. He got the moderna vaccine, he had an anaphylactic reaction about 20 mins after the shot. They took him to the hospital and had to give him another epi shot. He was released the next day.

Dd has allergies to tree nuts. My dd had an anaphylactic reaction to the meningitis vaccine and could not take the second dose. Her doctor told us that she should take the J&J vaccine, that way she would not have to worry about taking a second dose in case she has an allergic reaction to the covid vaccine. 

Edited March 28, 2021 by SDMomof3

[wathe]

I think, but I'm not sure, that the PEG is specific to mRNA vaccines.  Hence the newness of worrying about PEG allergies and vaccines.

I know that Pfizer and Moderna covid vaccines do not contain gelatin or egg, which is great news for allergy peeps, because allergies to these particular common vaccine ingredients are much more common than PEG allergy.

Edited March 28, 2021 by wathe

[Bootsie]

I do not have a nut allergy, but I have had a serious allergic reaction to an IV drug that put me on the "caution" list.  I had the opportunity to get the Johnson and Johnson vaccine which I took.  It appears to have had fewer allergic reactions, but it is a newer vaccine so less is known.  One advantage was I only had to worry about an allergic reaction to one shot. 

I had my vaccine at a clinic at my university.  I thought they were well-prepared for any problems.  EMS was outside.  The director of the clinic came and talke to me personally about receiving the vaccine and made sure she knew all about my previous reaction.  They allowed DH to sit with me during the 30-minute waiting period; there were at least two monitors at all times to watch people for reactions and they had me sitting where they could reach out to me immediately.  The director came over and checked on me several times.  I had NO problems with an allergic reaction.

(DH had his vaccine at a CVS in a rural town--no monitoring after and limited medical facilties nearby; I would not have been comfortable with that setup given my previous reaction.)

I did have some side effects--about 8 hours later started running 101-102 fever and had chills through the night with a pounding headache the following day.  But, those were simply side effects and not anything related to an allergy.  

[wathe]

PEG allergic people tend to present as mystery allergy people who are allergic to a long list of seemingly unrelated drugs.  It's somewhat handy that it's in so many common drugs - if you've taken ibuprofen, or tylenol, or zyrtec, you've likely been exposed to PEG.  If you've taken those things without a reaction, you likely don't have a life-threatening PEG allergy. 

ETA OBviously it's not handy for those with PEG allergies to be allergic to so many drug preparations, but rather handy for those wondering if they have a PEG allergy; they've likely already had a PEG challenge and just don't realize it.

Edited March 28, 2021 by wathe

[wathe]

And for pfizer and moderna covid vaccine anaphylaxis, we are talking about 5 anaphylactic reactions per million doses administered.  It's not common.  (Which doesn't mean it's not real, of course.  It happens, and it's serious.  But it's also rare)

ETA: compared to, say, penicillin, with an anaphylaxis rate of more like 1 per 5000 doses administered.

ETA again:  we all like references here, so here's the CDC report citing 2.5 per million doses for Moderna, and 11 per million for Pfizer, which has since been revised to 5 per million, but too lazy to search for the original source for that, Reuters will have to do for now

 

 

Edited March 28, 2021 by wathe

[ktgrok]

14 hours ago, SDMomof3 said:

Dd has allergies to tree nuts. My dd had an anaphylactic reaction to the meningitis vaccine and could not take the second dose. Her doctor told us that she should take the J&J vaccine, that way she would not have to worry about taking a second dose in case she has an allergic reaction to the covid vaccine. 

Just for what it is worth, I think a single dose of Pfizer is still more protection than a single dose of J&J. 

[freesia]

14 hours ago, SDMomof3 said:

Dd has allergies to tree nuts. My dd had an anaphylactic reaction to the meningitis vaccine and could not take the second dose. Her doctor told us that she should take the J&J vaccine, that way she would not have to worry about taking a second dose in case she has an allergic reaction to the covid vaccine. 

This is what dh is planning. His allergist told him to bring his epipen. He only wants to go through it once. 

[crazyforlatin]

14 hours ago, wathe said:

And for pfizer and moderna covid vaccine anaphylaxis, we are talking about 5 anaphylactic reactions per million doses administered.  It's not common.  (Which doesn't mean it's not real, of course.  It happens, and it's serious.  But it's also rare)

ETA: compared to, say, penicillin, with an anaphylaxis rate of more like 1 per 5000 doses administered.

ETA again:  we all like references here, so here's the CDC report citing 2.5 per million doses for Moderna, and 11 per million for Pfizer, which has since been revised to 5 per million, but too lazy to search for the original source for that, Reuters will have to do for now

 

 

It helps when you break down the numbers like this.

We’ve never had to use an epipen, so it’s the noise around the vaccine plus the possibility of an unknown reaction and having to use an epipen that makes me not want to do anything, but Dd needs to resume being a teen again.

[ktgrok]

14 minutes ago, crazyforlatin said:

It helps when you break down the numbers like this.

We’ve never had to use an epipen, so it’s the noise around the vaccine plus the possibility of an unknown reaction and having to use an epipen that makes me not want to do anything, but Dd needs to resume being a teen again.

Also, there is no reason to believe that this vaccine is any more likely to cause a reaction than say, a new body wash or whatever. 

[Spryte]

22 minutes ago, crazyforlatin said:

It helps when you break down the numbers like this.

We’ve never had to use an epipen, so it’s the noise around the vaccine plus the possibility of an unknown reaction and having to use an epipen that makes me not want to do anything, but Dd needs to resume being a teen again.

Kind of an aside, but if you’ve never used your epipens... that unknown adds extra stress.  You’ve probably done this, but ... Have you practiced with your expired epis?  That helps our kids a bit.  Practice on an orange.  Be careful not to stab yourself!  

[wathe]

4 minutes ago, Spryte said:

Kind of an aside, but if you’ve never used your epipens... that unknown adds extra stress.  You’ve probably done this, but ... Have you practiced with your expired epis?  That helps our kids a bit.  Practice on an orange.  Be careful not to stab yourself!  

We do this.  My kids administer expired epinephrine to apples.

[Spryte]

5 minutes ago, wathe said:

We do this.  My kids administer expired epinephrine to apples.

It helps with the unknown factor, doesn’t it? As they got older, we let some trusted friends do it, too, in case they were out together.

[wathe]

14 minutes ago, wathe said:

We do this.  My kids administer expired epinephrine to apples.

Quoting myself to add:  even if you do accidentally stab yourself, nothing bad will happen.  You will know what it feels like to have epi on board, and will have had valuable learning experience.  A colleague of mine accidentally got himself in the thumb with an epipen once.  Lesson learned and no harm done (the whole epi to the finger will make your finger fall off thing is a myth!)

[Spryte]

13 minutes ago, wathe said:

Quoting myself to add:  even if you do accidentally stab yourself, nothing bad will happen.  You will know what it feels like to have epi on board, and will have had valuable learning experience.  A colleague of mine accidentally got himself in the thumb with an epipen once.  Lesson learned and no harm done (the whole epi to the finger will make your finger fall off thing is a myth!)

Ha!  That’s true!  You’d just know what it feels like. Which could be good, our first epipen experience was kind of a shock - we just didn’t know what to expect.

I wouldn’t have thought anything bad would happen, just a kid might have an ouch.  Is that really a myth?  Eek.  Glad we never heard that one!

Practicing definitely made my super allergic kids more confident and comfortable.  And when we had their besties practice, that made me feel better, too.  😊

[crazyforlatin]

Great idea on stabbing an apple, we have plenty of expired epipens.

[wathe]

4 minutes ago, crazyforlatin said:

Great idea on stabbing an apple, we have plenty of expired epipens.

We also tend to have expired apples...... #foodwaste.  Need to work on that.....

[Bootsie]

2 hours ago, ktgrok said:

Also, there is no reason to believe that this vaccine is any more likely to cause a reaction than say, a new body wash or whatever. 

The rates I have seen are about 4 cases per million doses of anaphylactic reaction to COVID vaccines.  Is there any evidence that there is a 4 out of 1 million people who try a new body wash have a anaphylactic reaction?  

[ktgrok]

2 minutes ago, Bootsie said:

The rates I have seen are about 4 cases per million doses of anaphylactic reaction to COVID vaccines.  Is there any evidence that there is a 4 out of 1 million people who try a new body wash have a anaphylactic reaction?  

Body wash was probably a bad example, but there are things much more likely to trigger a reaction. my brain isn't working well today due to - ironically enough - my allergies. 

[Bootsie]

1 hour ago, ktgrok said:

Body wash was probably a bad example, but there are things much more likely to trigger a reaction. my brain isn't working well today due to - ironically enough - my allergies. 

From what little information that we have, it appears that the COVID vaccine has a higher rate of anaphylaxis than other vaccines.  This article suggests that the rate for all vaccines is 1.3/millionVaccine-Associated Anaphylaxis | SpringerLink.  That puts COVID vaccines at 3-4 times the rate of all vaccines (from the limited data we have).  That is still very low.  And, from what I have seen food allergies have not appeared to put people at higher risk of a severe allergic reaction to the COVID vaccines (although it has been several weeks since I looked at that data and the recommendations have changed often).  For most people, even in the caution group, many medical professionals are still saying the benefits outweigh the risks, but I would not want to trivialize that risk. 

I fall into that caution group but did choose to receive the vaccine (I may have waited longer to gather more evidence about COVID if I were not concerned about the risk of COVID to people around me, although it is uncertain how much the vaccine does help with that); I did so after careful review of the best information we have and in a setting where I was comfortable getting emergency care if needed (I would not have been comfortable in the setting in which DH received his).