Seasonal allergy sufferers are well aware: Pollen has arrived in full force. Fortunately, allergy medicine can help. But between sneezes and itchy eyes, some readers are asking, “Is it OK to keep taking my antihistamine medications if I’m about to go get the COVID-19 vaccine?”

With an array of allergy questions posed to our Curious Philly platform, we looked into the topic of allergies in relation to the COVID-19 vaccine. Here’s what you should know.

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Should I stop taking my allergy medicine before my vaccine appointment?

You don’t need to stop taking your regular allergy medicines if you’re getting the COVID-19 vaccine.

“If every springtime you take your Zyrtec and use your nose sprays, absolutely you should continue taking those,” says Shirley Fung, an allergy and immunology specialist at Jefferson Health. “There’s no concern it will interfere with the efficacy of the vaccine.”

If you’re taking stronger, immune-suppression medications, like prednisone, talk to your doctor before getting vaccinated. The vaccine is considered safe if you’re immunocompromised, but research is still underway on the efficacy of the vaccine for immunocompromised people.

Over-the-counter allergy medicines, like Zyrtec, Flonase, Claritin, and Allegra, however, don’t require a discussion with your doctor. You may even want to set a reminder to take your medicine, especially if you see a high pollen count on the day of your appointment.

“Obviously the benefit of getting your COVID vaccine as soon as possible is important, but if you’re already stuffy and sneezy, and you add to that the potential of more side effects later, that might not feel good,” says Scott Feldman, a physician and assistant professor of medicine in the section of allergy and immunology at Penn Medicine. “You may want to take your maximum allergy medication to control your allergies if it’s a particularly bad day.”

Make sure you’re wearing a tight-fitting mask. While masks are required at vaccination appointments to keep yourself and others protected, wearing a mask may benefit you en route to your appointment, too.

“It’s allergy season now, so I encourage my patients to check their pollen count, take their medicines daily when the counts are high, and wear a mask — if you’re outside, a tight-fitting mask can help filter out the allergens,” says Fung.

Although the Centers for Disease Control and Prevention recently loosened its guidance on masking outside, it could be one reason to leave your mask on.

If I don’t usually take allergy medicine, should I take it to prevent an allergic reaction to the vaccine?

No. There’s no need to suddenly start taking allergy medicines if you’ve never taken them before. Using antihistamines to prevent an allergic reaction to the vaccine is not recommended.

Likewise, the CDC doesn’t recommend taking over-the-counter medicine, such as ibuprofen, aspirin, or acetaminophen, before vaccination for the purpose of trying to prevent vaccine-related side effects.

“If you’re worried, your best strategy is not premedication, but to talk to your doctor so that you can try to alleviate some of that anxiety,” says Feldman. “In general, these vaccines have been very safe and we’ve seen very few true allergic reactions.

Should I worry about a severe allergic reaction to the vaccine?

An allergic reaction is considered severe when a person needs to be treated with epinephrine or an EpiPen or if the person must go to the hospital, says the CDC. This includes anaphylaxis, a reaction that includes symptoms such as wheezing, nausea, vomiting, hives, dizziness, and/or fainting.

“Your chances of a severe reaction aren’t zero, but it’s a very small chance, and people have to understand that allergic reactions are treatable,” says Fung.

Post-vaccination anaphylaxis occurred in approximately two to five people per million vaccinated in the United States, according to the CDC. This kind of allergic reaction almost always occurs within 30 minutes after vaccination, and vaccine staff have medicines to immediately treat it.

Seasonal allergies aren’t going to cause you to have a severe reaction. If you’ve had severe allergic reactions in the past from food, pets, venom, latex, environmental allergies, or oral medications, you also remain advised to get the COVID-19 vaccine.

“There are no food components or latex in any of the vaccines,” says Fung. “If you have a history of anaphylaxis from an egg or peanut or bee sting allergy, we tell people to bring an EpiPen and be prepared to wait for a 30-minute observational period. But it’s a precaution, and it goes for anyone with a history of anaphylaxis in general.”

You can read about the ingredients in the vaccines here. If you’ve had a severe allergic reaction or an immediate allergic reaction to any ingredient in the Pfizer or Moderna vaccines, such as polyethylene glycol, you shouldn’t get either of those vaccines. If you’ve had a severe allergic reaction or an immediate allergic reaction to any ingredient in the Johnson & Johnson vaccine, such as polysorbate, you shouldn’t get the J&J vaccine. Depending on your allergy history, your doctor may advise one vaccine over another.

You should also talk to your doctor if you’ve had an immediate allergic reaction to a vaccine or injectable therapy for another disease. Your doctor will help you decide if it’s safe for you to get vaccinated.

Not sure if you’re allergic to an ingredient in the vaccines? Don’t panic. It’s believed that allergic reactions are related to the polyethylene glycol (in Pfizer and Moderna) and the polysorbate (in J&J), and allergies to both ingredients are very rare, says Fung. If you can’t recall a history of reaction to either ingredient, in most cases you’ll be advised to get the vaccine. Talk to your doctor or allergist if you’re feeling nervous.

“It’s important to remember that the risk of having a severe COVID infection still outweighs the risk of a severe allergic reaction,” says Fung.

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Expert sources:
  • Scott Feldman, M.D., Ph.D, is a physician and assistant professor of medicine in the section of allergy and immunology at Penn Medicine

  • Shirley Fung, M.D., is an allergy and immunology specialist at Jefferson Health