Please check if you are eligible to receive the COVID-19 Vaccine here.

We hope that you continue to remain well. With the ongoing pandemic and increasing COVID-19 vaccination rates, our office wanted to share with you our views based on current available information. 

We believe that vaccination is a strong step towards minimizing the effects of COVID-19.

The Pfizer and Moderna mRNA vaccines and the AstraZeneca viral-based vaccine are currently being administered in Canada. A viral-based vaccine from Johnson and Johnson was also approved. Millions of doses of COVID-19 vaccines have been already safely administered around the world. The efficacy against severe to moderate COVID-19 infections is estimated to be:

• Pfizer - 95% 

• Moderna - 94%

• Johnson & Johnson (Janssen) - 64%

• AstraZeneca - 63% 

The following are the approved age groups and recommended doses for each vaccine:

In general, there may be common side effects similar to other vaccines such as pain at the injection site, feeling tired, or feeling feverish, but these are normal responses and do not pose a risk to health. 

There have been reports of allergic reactions after receiving the mRNA COVID-19 vaccines. However, these remain rare with only about 4.5 anaphylactic reactions per million doses, which is similar to that of other vaccinations.  This vaccine is very safe, and severe allergic reactions are very rare. The overwhelming majority of vaccine recipients are well - Dr. Ohayon and our staff included!

Although the exact cause of the allergic reactions are yet to be confirmed, of all the components of the mRNA COVID vaccines, it is felt that the outer ring of the vaccine containing “Polyethylene Glycol” (known as “PEG”) is the probable allergen. PEG is commonly found in laxative medications such as Restorolax over the counter.  Polyethylene Glycol (PEG) is NOT similar to Propylene Glycol, found commonly as a contact allergen.  

The Pfizer-BioNTech and Moderna COVID-19 vaccines contain different forms of PEG. The AstraZeneca and Janssen (Johnson & Johnson) COVID-19 vaccines contain polysorbate 80. Polysorbate 80 is found in many other vaccines such as Tetanus both for adults and children, Hepatitis B, influenza, Meningitis, Rotavirus commonly used in our community with minimal to no allergic reactions.

In review of the data so far available about the few allergic cases worldwide, the body representing Allergists in Canada known as the Canadian Society of Allergy and Clinical Immunology Control (CSACI) have stated that in the case of “Allergy sufferers”, 

“only persons with an absolute contraindication to vaccination (see below) should not receive the vaccine for now.” 

An absolute contradiction includes either of the following:

• Severe allergic reaction (anaphylaxis) to any of the Covid vaccine components.  

• Immediate allergic reaction of any severity to a previous dose of a COVID-19 vaccine or any of its components.

The complete list of components for the two mRNA COVID-19 vaccines are listed below.

Additionally, the complete list of components in the vector-based vaccines:

The AstraZeneca COVID-19 vector-based vaccine contains:

• Medicinal ingredient

  • Adenovirus vector vaccine

• Non-medicinal ingredients

  • disodium edetate dihydrate (EDTA)

  • ethanol

  • L-histidine

  • L-histidine hydrochloride monohydrate

  • magnesium chloride hexahydrate

  • polysorbate 80

  • sodium chloride

  • sucrose

  • water for injection

Adverse Reactions - Vaccine-Induced Blood Clots

The National Advisory Committee on Immunizations (NACI) is currently investigating the adverse events recorded with respect to the COVID-19 vaccine. 

There have also been rare case reports of blood clots, known as Vaccine-Induced Prothrombotic Immune Thrombocytopenia (VIPIT), after receiving the AstraZeneca COVID-19 Vaccine, primarily in women under the age of 55. Recently, a minute number of blood clots were reported with the Johnson&Johnson vaccine as well. 

This is thought to be due to a kind of antibody stimulating platelets, a type of blood cell, to form clots. The rate of the blood clots has not been confirmed in Canada. 

While this is being investigated, NACI recommends that the AstraZeneca vaccine is not given to those under the age of 55 out of precaution. As per the European Medicine Agency, the current investigative body into these adverse reactions, COVID-19 is associated with a risk of hospitalisation and death. The reported combination of blood clots and low blood platelets is very rare, and the overall benefits of the vaccine in preventing COVID-19 outweigh the risks of side effects.

Summary Recommendations:

For now, the recommendations by Health Canada’s National Advisory Council on Immunization (NACI) and Centre for Disease Control (CDC) have recommended that patients with known allergy to components of the COVID vaccines should not receive the vaccine.  This includes:

Patients with a known polysorbate allergy should not receive the AstraZeneca, or Janssen (Johnson & Johnson) vaccine. Polysorbate allergy is a precaution to receiving the Pfizer or Moderna mRNA vaccines. 

Persons with a known Polyethylene Glycol (PEG) allergy should not receive the Pfizer or Moderna vaccine. They also have a precaution to receiving the Janssen (Johnson & Johnson) vaccine. 

If you have been labeled as having allergies to other immunizations or vaccines then you are advised to seek medical advice for reassurance that you are not at risk of having an allergic reaction to the COVID vaccine. 

Otherwise, if you have other common allergic conditions such as food allergies, insect sting reactions, asthma, hayfever, penicillin or other medication allergies, there is NO increased risk of concern for allergic reactions to the COVID-19 vaccine.

As with all medical information on the internet, the above is provided to help explain the general issue of allergy to the COVID vaccines and provide direction as to who is and is not at risk for allergic reactions.  If you have specific questions after reading the above, we ask that you arrange to talk to your doctor for further specific advice.

We hope that our community may be promptly and safely immunized to coronavirus to help control and bring this pandemic to an end.

Dr. Ohayon and Staff

Last updated: April 9th, 2021

REFERENCES:

1. Health Canada. Vaccines for COVID-19: Authorized vaccines. Retrieved from: https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines.html

2. Health Canada. AstraZeneca COVID-19 vaccine: What you should know. Retrieved from:

3. https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/astrazeneca.html

4. Health Canada. Janssen COVID-19 vaccine: What you should know. Retrieved from:

5. https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines/janssen.html#a5

6. Canadian Society of Allergy and Immunology. Press Release. Retrieved from: https://csaci.ca/wp-content/uploads/2020/12/PressRelease-Pfizer-COVID-19vaccine-DEC-14.pdf

7. CDC. COVID-19 Vaccination. Retrieved from: https://www.cdc.gov/vaccines/covid-19/index.html

8. CDC. Janssen COVID-19 Vaccine (Johnson & Johnson). Retrieved from: https://www.cdc.gov/vaccines/covid-19/info-by-product/janssen/index.html

9. NACI rapid response: Recommended use of AstraZeneca COVID-19 vaccine in younger adults:. https://www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci/rapid-response-recommended-use-astrazeneca-covid-19-vaccine-younger-adults.html