{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T22:22:12Z","timestamp":1780525332819,"version":"3.54.1"},"reference-count":39,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2021,6,15]],"date-time":"2021-06-15T00:00:00Z","timestamp":1623715200000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Allergy"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The first approved COVID\u201019 vaccines include Pfizer\/BioNTech BNT162B2, Moderna mRNA\u20101273 and AstraZeneca recombinant adenoviral ChAdOx1\u2010S. Soon after approval, severe allergic reactions to the mRNA\u2010based vaccines that resolved after treatment were reported. Regulatory agencies from the European Union, Unites States and the United Kingdom agree that vaccinations are contraindicated only when there is an allergy to one of the vaccine components or if there was a severe allergic reaction to the first dose. This position paper of the European Academy of Allergy and Clinical Immunology (EAACI) agrees with these recommendations and clarifies that there is no contraindication to administer these vaccines to allergic patients who do not have a history of an allergic reaction to any of the vaccine components. Importantly, as is the case for any medication, anaphylaxis may occur after vaccination in the absence of a history of allergic disease. Therefore, we provide a simplified algorithm of prevention, diagnosis and treatment of severe allergic reactions and a list of recommended medications and equipment for vaccine centres. We also describe potentially allergenic\/immunogenic components of the approved vaccines and propose a workup to identify the responsible allergen. Close collaboration between academia, regulatory agencies and vaccine producers will facilitate approaches for patients at risks, such as incremental dosing of the second injection or desensitization. Finally, we identify unmet research needs and propose a concerted international roadmap towards precision diagnosis and management to minimize the risk of allergic reactions to COVID\u201019 vaccines and to facilitate their broader and safer use.<\/jats:p>","DOI":"10.1111\/all.14739","type":"journal-article","created":{"date-parts":[[2021,1,16]],"date-time":"2021-01-16T09:21:05Z","timestamp":1610788865000},"page":"1629-1639","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":99,"title":["EAACI statement on the diagnosis, management and prevention of severe allergic reactions to COVID\u201019 vaccines"],"prefix":"10.1111","volume":"76","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9710-6685","authenticated-orcid":false,"given":"Milena","family":"Sokolowska","sequence":"first","affiliation":[{"name":"Swiss Institute of Allergy and Asthma Research (SIAF University of Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2914-7829","authenticated-orcid":false,"given":"Thomas","family":"Eiwegger","sequence":"additional","affiliation":[{"name":"Division of Immunology and Allergy Food Allergy and Anaphylaxis Program The Hospital for Sick Children Toronto ON Canada"},{"name":"Translational Medicine Program, Research Institute The Hospital for Sick Children Toronto ON Canada"},{"name":"Department of Immunology University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Ollert","sequence":"additional","affiliation":[{"name":"Department of Infection and Immunity Luxembourg Institute of Health Esch\u2010sur\u2010Alzette Luxembourg"},{"name":"Department of Dermatology and Allergy Center Odense Research Center for Anaphylaxis Odense University Hospital University of Southern Denmark Odense Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5228-471X","authenticated-orcid":false,"given":"Maria J.","family":"Torres","sequence":"additional","affiliation":[{"name":"AllergyClinical Unit Hospital Regional Universitario de M\u00e1laga\u2010UMA\u2010ARADyAL M\u00e1laga Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5488-5700","authenticated-orcid":false,"given":"Domingo","family":"Barber","sequence":"additional","affiliation":[{"name":"Departamento de Ciencias M\u00e9dicas B\u00e1sicas Facultad de Medicina Instituto de Medicina Molecular Aplicada (IMMA Universidad San Pablo\u2010CEU CEU Universities Madrid Espa\u00f1a"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4517-1749","authenticated-orcid":false,"given":"Stefano","family":"Del Giacco","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences and Public Health University of Cagliari Cagliari Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Jutel","sequence":"additional","affiliation":[{"name":"Department of Clinical Immunology Wroc\u0142aw Medical University Wroc\u0142aw Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2146-2955","authenticated-orcid":false,"given":"Kari C.","family":"Nadeau","sequence":"additional","affiliation":[{"name":"Sean N. Parker Center for Allergy and Asthma Research at Stanford University Stanford University Stanford CA USA"},{"name":"Department of Medicine Division of Pulmonary and Critical Care Medicine Stanford University Stanford CA USA"},{"name":"Department of Medicine Division of Allergy, Immunology and Rheumatology Stanford University Stanford CA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4516-0369","authenticated-orcid":false,"given":"Oscar","family":"Palomares","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Biology Chemistry School Complutense University of Madrid Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald L.","family":"Rabin","sequence":"additional","affiliation":[{"name":"Office of Vaccines Research and Review Center for Biologics Evaluation and Research US Food and Drug Administration Silver Spring MD USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8745-0228","authenticated-orcid":false,"given":"Carmen","family":"Riggioni","sequence":"additional","affiliation":[{"name":"Allergy and Clinical Immunology Department of Paediatrics Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore"},{"name":"Institut de Recerca Sant Joan de D\u00e9u Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Vieths","sequence":"additional","affiliation":[{"name":"Paul\u2010Ehrlich\u2010Institut Paul\u2010Ehrlich\u2010Str. 51\u201059 Langen 63225 Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7994-364X","authenticated-orcid":false,"given":"Ioana","family":"Agache","sequence":"additional","affiliation":[{"name":"Transylvania University Brasov Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3425-3463","authenticated-orcid":false,"given":"Mohamed H.","family":"Shamji","sequence":"additional","affiliation":[{"name":"Immunomodulation and Tolerance Group, Allergy and Clinical Immunology Inflammation, Repair and Development National Heart and Lung Institute Imperial College London. 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