Patients with history of anaphylaxis can have Pfizer COVID jab, says MHRA

Patients with a history of severe allergy are now able to have the Pfizer/BioNTech COVID-19 vaccine, the MHRA has said.

(Photo: Leon Neal/Getty Images)
(Photo: Leon Neal/Getty Images)

An update on 30 December said that the only people who can no longer have the vaccine are those with a known allergy to any of its ingredients.

The new advice has been included in NHS England's updated standard operating procedure for PCN-led vaccination sites that was published on 5 January.

GPs had been advised not to give the Pfizer vaccine to any patient with a history of severe allergy to food or medicines following three adverse events on the first day of the COVID-19 vaccination programme. However, the MHRA has now reversed that advice.

The Green Book chapter on COVID-19 vaccines has been updated to reflect the new information.

Updated advice

It says that the Pfizer vaccine contains polyethylene glycol (PEG), which is 'from a group of known allergens commonly found in medicines and also in household goods and cosmetics'.

The Green Book adds: 'Known allergy to PEG is extremely rare but would contraindicate receipt of this vaccine. Patients with undiagnosed PEG allergy may have a history of unexplained anaphylaxis or of anaphylaxis to multiple classes of drugs. The AstraZeneca vaccine does not contain PEG and is a suitable alternative.'

It goes on to say that 'following close surveillance of the initial roll-out' the MHRA has now advised that anyone with a severe history 'to food, an identified drug or vaccine, or an insect sting can receive any COVID-19 vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine'.

The advice remains that anyone having the Pfizer jab should be monitored for 15 minutes, or longer if clinically indicated.

The NHS England standard operating procedure has been updated to include information about the Oxford/AstraZeneca vaccine and provide further advice about vaccinations in care homes and for housebound patients now this vaccine is available.

An NHS England webinar yesterday indicated that PCN sites will be receiving the first doses of the Oxford jab on Thursday and Friday of this week. At present the SOP suggests that patients receiving the Oxford vaccine may need to be observed for 15 minutes, however NHS England has suggested this recommendation could change in the coming days.

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