In general, persons with an immediate allergic reaction to the first dose should not receive additional doses. For the purposes of this guidance, an immediate allergic reaction to a vaccine or medication is defined as any hypersensitivity-related signs or symptoms, such as anaphylaxis, urticaria, angioedema, respiratory distress (e.g. wheezing, stridor), that occur within hours of administration. However, subject to individual risk-benefit assessment, specialist services for immunization may allow COVID-19 vaccines to be provided under close medical supervision if it is the only available option for persons at high risk of severe COVID-19.
As a small number of anaphylactic reactions have also been reported in vaccinees without a history of severe allergic reactions, WHO recommends that COVID-19 vaccines should be administered only in settings where anaphylaxis can be treated. Until more data and insights are available with regard to severe allergic reactions to COVID vaccination, all vaccinees should be observed for at least 15 minutes after vaccination.
- Immediate or severe reactions after a previous dose are contraindications
- Administer COVID-19 vaccines only where anaphylaxis can be treated
- Observe all vaccines at least 15 minutes after vaccination.