Sputnik V or CoviVac — what person with allergy should choose?
If a vaccine against coronavirus is safe if there is an allergy
How to be vaccinated against coronavirus and avoid hospitalisation if one has an allergy? Director of the urban Centre of Allergology and Immunology of Hospital No. 7 in Kazan Guzel Zakirova explained Tatarstan residents about the specifics of vaccination in a live of the republic’s coronavirus taskforce. The immunologist also explained why taking antihistamines was a bad idea to save yourself from a reaction to a vaccine. Realnoe Vremya has published the doctor’s key recommendations for patients with allergies.
People with rhinitis shouldn’t hurry to receive a vaccine
Director of the urban Centre of Allergology and Immunology of Hospital No. 7 in Kazan Guzel Zakirova advises all people with an allergy to receive a vaccine only in remission. The doctor reminded them that an allergy has two stages: remission and aggravation. People with a confirmed allergy that is a reaction to dust, animals, pollen of plants such as trees, crops, weeds or, for instance, insect stings, medicines should and can be vaccinated only in remission.
Guzel Zakirova doesn’t advise people suffering from rhinitis at this moment and postpone the vaccination until early October.
“The third wave of allergies to pollen is starting. People with rhinitis can react to weeds: artemisia, saltbush, elytrigia, ragweed. Patients can have a runny nose, watery, itchy eyes, asphyxia. This group of people isn’t subject to vaccination because the disease is at an acute stage. They can be vaccinated approximately in early October when the aggravation is over, people recover.
If there is an allergy to insect bites, a doctor anyway recommends vaccination, but people should try to avoid bites, as a consequence, a manifestation of allergy: “No bite, no allergic reaction. It means a person can be vaccinated.”
The same rule is applied for people who have drug allergies: “If there is a drug allergy, but this person is not taking this medicine, he doesn’t have complaints, he can also be immunised.”
According to the doctor, people with immunodeficiency, anaphylaxis, acute severe reactions to medicines in their medical history, with systemic lesions have a permanent medical exemption.
Neither will a person who had a manifested reaction to the first dose of a specific vaccine — with a high temperature of 40 degrees and convulsions — receive the second dose of the vaccine.
What reactions of the organism can be frightening but aren’t dangerous in fact
Guzel Zakirova also talked about frequent symptoms people have during vaccination but they aren’t dangerous.
“There are a lot of states resembling anaphylaxis. Not every state with low pressure and giddiness is a shock. The injection is painful enough, but some patients respond to the pain with a fall in the blood pressure, it is a vegetative reaction of the organism, not a shock.”
The doctor explained that real anaphylaxis doesn’t develop instantaneously.
“The organism must be familiar with medicine as an allergen to react to it — the immune system must have antibodies precisely to this medicine. And when it has never met with this medicine, there can’t be real allergic anaphylaxis.”
Nevertheless, if a person is very sensitive to any chemical substances or reacts to stress, cold, heat or the sun with hives, he can develop hives after vaccination. But they don’t appear right away, the doctor added.
Simplest rules to get through vaccination
Any vaccine is stressful for the organism, the doctor reminded the audience. Due to this, Guzel Zakirova gave people simple recommendations they can use to minimise possible unpleasant consequences of vaccination:
“A person should be full, drink a lot of water, especially in hot weather, one shouldn’t stay in the sun for long before vaccination, it shouldn’t be stifling, hot in the room. After vaccination, it is necessary to stay in the health care establishment for half an hour, avoid physical exercise, sun.”
If people with autoimmune diseases should be vaccinated or not
In case of a severe poorly controlled disease when a patient is overseen by rheumatologists, endocrinologists, neuropathologists, other doctors, takes medicine, there is a risk of aggravation of the main disease during vaccination, the doctor assumes.
“It is necessary to be careful about vaccination, in this case, there can be a medical exemption. But if there is an autoimmune disease, the same autoimmune thyroiditis, which is widely spread, is controlled, there is no contraindication to vaccination.”
Which vaccine will suit people with allergies best
Guzel Zakirova thinks that it is safer for people with allergies to receive the Sputnik V (Gam-COVID-Vac) because the doctor says it doesn’t contain peptides, proteins, the vaccine has few components.
“For people with allergy, the simpler the composition, the fewer components, the better.”
The CoviVac vaccine has less strict contraindications for people who have ever had an anaphylactic shock to any medicines, allergy to vaccines, the doctor thinks.
All the three vaccines — CoviVac, Sputnik V, EpiVacCorona — have contraindications to receiving the second dose. It is hyperthermia as a reaction to the first dose: a temperature above 40 degrees, convulsions, a local reaction as redness more than 8 cm in diameter.
In this case, the doctor recommends seeing an allergy specialist and consider another vaccine some time later. Guzel Zakirova paid attention to the fact that it is not necessary to receive another vaccine immediately — in three weeks.
“A doctor should find out if the patient had a real reaction to the vaccine because there are a lot of false reactions.”
Guzel Zakirova put an example of three patients of the Allergy Unit who were admitted with “post-vaccination reaction.”
The first patient had an allergy to weed pollen in the acute phase and he shouldn’t have been vaccinated at that moment. After vaccination, he developed hives. The second patient had an aggravation of herpes infection, and again he shouldn’t have been immunised in the acute period. While a day to the vaccination the third patient had been in the sun and also reacted to the vaccination.
Why allergy pills will not help
It is not necessary to take antihistamines in advance, the doctor is convinced.
“It is considered that antihistamines reduce the immune response. Also, they work only for a specific immune response, certain allergic reactions. And this may not coincide with what’s happening in a person’s organism during vaccination, and there won’t be an expected effect.”
However, the doctor says if a person has an allergy and is taking antihistamines as a basic therapy, he should keep taking them.
“If a person is taking antihistamines, it means there is aggravation and he cannot be immunised. It is necessary to be able to cancel these medicines, be in remission and receive a vaccine then.”