GPs were initially advised not to give the Pfizer/BioNTech vaccine to any patient with a history of severe allergy to food or medicines, after three adverse events occurred on the first day of the COVID-19 vaccination programme. However, the MHRA has now withdrawn that advice.
Patients with a history of systemic allergic reactions can now receive any COVID-19 vaccine provided they are not known to be allergic to any of its ingredients.
For patients who are allergic to polyethylene glycol (PEG), found in the Pfizer/BioNTech vaccine, the Oxford/AstraZeneca vaccine is a suitable alternative.
The Green Book says that known allergy to PEG is 'extremely rare'. Patients with undiagnosed PEG allergy may have a history of unexplained anaphylaxis or of anaphylaxis to multiple classes of drugs, it says.
Updated pregnancy advice
Prescribing information for the Pfizer/BioNTech vaccine has also been updated to reflect the latest advice that pregnant and breastfeeding women can now have the vaccine if the potential benefits are thought to outweigh the potential risks. They are no longer advised to avoid getting pregnant for two months after having the jab.
The advice remains that anyone having the Pfizer jab should be monitored for 15 minutes, or longer if clinically indicated. This is not needed for the Oxford/AstraZeneca vaccine.
The patient group direction (PGD) for the vaccine has been updated to reflect the new allergy advice, and to allow for administration of a sixth dose of the jab from the vial if this is possible.
The updated PGD says that when administering a sixth dose 'care should be taken to ensure a full 0.3ml will be administered. Where a full 0.3ml dose cannot be extracted the contents should be discarded.'