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SPIEGEL: Mr Klimek, two people in Britain suffered what is known as anaphylactic shock after Biontech’s Covid 19 vaccination, and there are also first cases in the US Do people with allergies now have to worry about not tolerating the vaccination?
Klimek: Allergic reactions are the most serious side effects of the vaccine to date. All hell has been breaking loose on allergy practices in Germany these days because many patients have questions about it. What is very important: Although an estimated 24 million people in Germany have allergies, only a fraction of them have a severe allergy that can prevent vaccination. Therefore, it affects a smaller group, not all allergy sufferers.
This severe allergic reaction is a life-threatening emergency. The body reacts violently to an allergen, affecting various organs. In addition to skin reactions, dizziness or vomiting may occur. Those affected may suffer a circulatory collapse. Shock occurs very quickly after contact with the allergen. Patients are treated with adrenaline, cortisone, and an antiallergic agent. If you react quickly, anaphylactic shock is easily treatable.
SPIEGEL: Do you have a couple of examples?
Klimek: If you have hay fever or house dust allergy, but have no other allergies, there is no need to worry. However, if you have multiple food allergies or are allergic to multiple medications, you should clarify whether vaccination is an option for you. In a statement of which I am a co-author, allergy societies assume that around one to three percent of the population is at risk for anaphylaxis, so they should not be vaccinated or should only be vaccinated with protective measures.
SPIEGEL: What kinds of allergies do people who have suffered anaphylactic shock after vaccination have?
Klimek: The two people in the UK suffered from multiple food and drug allergies. In the US, however, there is also a case in a woman who was previously not known to have an allergy. Something like that also happens.
SPIEGEL: Do you already know what caused the allergic reaction?
Klimek: We still don’t know what caused the anaphylactic shock. That needs to be clarified urgently. But we have a prime suspect because we know him: PEG, polyethylene glycol. In the vaccine, PEG is contained in the protective covering that carries the RNA from the vaccine to the cells. The substance is used in medicines and cosmetics, but allergies are known.
SPIEGEL: Is it possible to become sensitized to PEG through vaccination, that is, to develop an allergy to this substance?
Klimek: Yes, it is basically possible. This is always the case when adding bioactive substances and is by no means a specific problem with this vaccine. But there will definitely be people who become sensitized to PEG through vaccination.
SPIEGEL: What is the best way to cope with the risk of anaphylactic shock?
Klimek: The suggestion we allergists make is to divide people into a kind of traffic light system based on their allergies prior to vaccination. If it’s green, you can safely get vaccinated. Those who are yellow should stay at the vaccination center for half an hour after vaccination to be safe. In the event of anaphylactic shock, medical personnel are immediately available to help. Anyone that is red should be tested prior to vaccination to determine if there is an allergy to PEG or other substances in the vaccine. If there is an allergy, this would be an exclusion criterion, you should not be given this vaccine. If it doesn’t exist, severe allergy sufferers can also be vaccinated.
