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Health experts on how to handle severe, immediate reactions from COVID vaccine

Two Colorado health experts said severe reactions to COVID-19 vaccines are rare, but here's what people should do if they experience non-emergent symptoms.

COLORADO, USA — The Centers for Disease Control and Prevention (CDC) recommends that those who experience a severe or immediate allergic reaction to their first COVID-19 vaccine should not get their second dose.  

The CDC considers an allergic reaction to be severe when someone needs to be treated with an EpiPen or if they must go to the hospital. This kind of reaction is also known as anaphylaxis. An immediate allergic reaction happens within four hours of getting vaccinated, according to the CDC.

"Immediate hypersensitivity reactions or anaphylactic reactions are actually quite unlikely with the COVID-19 vaccines," said Dr. Anjeli Kalra, an allergist with UCHealth. "The only contraindication to the Moderna and Pfizer vaccines is a history of anaphylaxis to polyethylene glycol (PEG) and the only contraindication to the Johnson and Johnson vaccine is a history of anaphylaxis to polysorbate 80."

Kalra said it's important to know the symptoms of anaphylaxis before opting out of receiving your second dose. 

"Symptoms will include diffused redness of the skin, hives, swellings of the lips or tongue and 90% of people who have anaphylaxis to the vaccine will have skin findings, in addition to wheezing, trouble breathing, diarrhea, nausea, vomiting and/or loss of consciousness," she said. 

Professor of immunology with the CU College of Medicine, Dr. Ross Kedl, also said that severe reactions to COVID-19 vaccines are rare. For people who had a reaction to Pfizer or Moderna, Kedl said the Johnson and Johnson vaccine may be a better option, but only after discussing it with your doctor. 

"If someone had an allergic reaction to Pfizer then switched to J&J, and then had an allergic reaction to J&J, well they’ve had two doses, and so frankly, they’re done so good news, if they don’t need to worry too much, that shouldn’t negatively affect their immunity," said Kedl.

After having a reaction to either Pfizer or Moderna, patients who are given the green light to get the Johnson & Johnson vaccine after consulting their doctor should wait 28 days after their first COVID vaccine dose, Kalra recommended. 

The Colorado Department of Public Health and Environment said vaccine providers are required to report any adverse events following a COVID-19 vaccine to the Vaccine Adverse Event Reporting System (VAERS). 

After receiving the vaccine, people should get a v-safe information sheet telling them how to enroll in v-safe, a smartphone-based, after-vaccination health checker. 

Those enrolled receive regular text messages directing them to surveys where they can report any problems or adverse reactions they have after receiving a COVID-19 vaccine. V-safe is available in English, Korean, simplified Chinese, Spanish and Vietnamese.

Kedl and Kalra recommend going over symptoms of the first dose reaction with a primary care doctor, allergist, or immunologist before getting a second dose. 

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