Can People with Chronic Hives Safely Get the COVID Vaccine?

Q: Can People with Chronic Hives Safely Get the COVID Vaccine?

Dear Ms. <br>Lee：<br>1. <br>The AstraZeneca COVID-19 vaccine contains a non-replicating adenoviral vector carrying the gene for the SARS-CoV-2 spike protein (S protein), as well as L-Histidine, L-Histidine hydrochloride monohydrate, magnesium chloride, Polysorbate 80, ethanol, su

Can individuals with urticaria receive the COVID-19 vaccine?

Hello Doctor: My father is 56 years old and he occasionally experiences sudden episodes of urticaria.
Whenever he feels itchy, he takes an antihistamine and it resolves the issue.
This occurs about once or twice a month and is not persistent.
He has hypertension, but it is not severe and is managed with medication.
Currently, he consumes about eight bottles of beer a day and has no other significant illnesses or discomfort.
Given his condition, would it be appropriate for him to receive the Moderna vaccine when it becomes available? Since he does not have a regular family doctor to consult, I would like to hear your opinion.
Thank you.

Li, 20~29 year old female. Ask Date: 2021/07/07

Dr. Xiao Yongxun reply Family Medicine

Dear Ms.
Lee:
1.
The AstraZeneca COVID-19 vaccine contains a non-replicating adenoviral vector carrying the gene for the SARS-CoV-2 spike protein (S protein), as well as L-Histidine, L-Histidine hydrochloride monohydrate, magnesium chloride, Polysorbate 80, ethanol, sucrose, sodium chloride, and disodium ethylenediaminetetraacetate (EDTA-2Na).
2.
The Moderna COVID-19 vaccine includes mRNA for the SARS-CoV-2 spike protein (S protein) and lipids {SM-102, polyethylene glycol [PEG] 2000 dimyristoyl glycerol [DMG], cholesterol, 1,2-distearoyl-sn-glycero-3-phosphocholine (DSPC)}, as well as tromethamine, tromethamine hydrochloride, acetic acid, sodium acetate, and sucrose.
3.
General food or medication allergies (not related to COVID vaccines or their components) are not contraindications for vaccination; however, if there is a history of anaphylaxis, it is advisable to inform the physician prior to vaccination.
Patients with chronic urticaria can receive the COVID vaccine, and it is recommended to continue taking their regular medications on the day of vaccination.
Mild urticarial symptoms may occur post-vaccination (often triggered by stressors), and if a severe allergic reaction occurs, it is advised to seek medical attention promptly.
4.
Regarding the use of antihistamines to prevent severe anaphylaxis, the Centers for Disease Control and Prevention (CDC) in the United States does not recommend this, as antihistamines cannot prevent anaphylaxis.
Prophylactic use may mask skin symptoms, leading to delayed diagnosis and management of allergic reactions.
5.
It is strongly recommended for patients with hypertension to receive the COVID vaccine, as it effectively reduces the risk of hospitalization and severe illness; they should also continue their regular antihypertensive medications.
6.
Based on your statement, there is no medical evidence indicating that your father should not receive the Moderna vaccine.
7.
In simple terms, individuals with a history of allergies to vaccine components are advised against vaccination; if there is no allergy history, it is recommended to observe at the vaccination site or nearby for at least 30 minutes after receiving the vaccine before leaving if no issues arise.
8.
Your father consumes eight bottles of beer a day, which may pose a risk of alcohol dependence; please ensure he seeks medical attention from a gastroenterologist.

Reply Date: 2021/07/07

More Info

When considering whether individuals with chronic hives (urticaria) can safely receive the COVID-19 vaccine, several factors must be taken into account, including their overall health, the nature of their hives, and any other underlying conditions they may have.

Firstly, chronic hives can be triggered by various factors, including allergens, stress, medications, and sometimes, the cause remains unknown. In your father's case, he experiences hives infrequently and manages them effectively with antihistamines. This suggests that his condition is relatively stable and well-controlled. Chronic hives alone do not typically contraindicate vaccination.
Regarding the COVID-19 vaccines, including Moderna, the Centers for Disease Control and Prevention (CDC) and other health authorities have indicated that individuals with a history of allergic reactions, including hives, can receive the vaccine. However, it is essential to differentiate between anaphylaxis (a severe allergic reaction) and milder allergic reactions. If your father has experienced only mild hives that resolve with antihistamines, he is generally considered safe to receive the vaccine.

It is also important to consider his other health condition—high blood pressure. If his hypertension is well-managed with medication and he does not have any other significant health issues, this should not pose a risk for vaccination. However, it is advisable for him to consult with a healthcare provider before getting vaccinated, especially since he consumes a considerable amount of alcohol (approximately eight bottles of beer daily). Excessive alcohol consumption can affect overall health and may interact with medications he is taking for hypertension, potentially complicating his health status.

In summary, based on the information provided, your father appears to be a suitable candidate for the COVID-19 vaccine, including the Moderna vaccine. However, it is crucial for him to discuss his specific health situation with a healthcare professional who can provide personalized advice. They may recommend monitoring him for any potential allergic reactions post-vaccination, especially since he has a history of hives.

Additionally, it is worth noting that vaccination is a critical tool in controlling the spread of COVID-19 and protecting individuals from severe illness. The benefits of vaccination generally outweigh the risks, especially for individuals with manageable health conditions.
In conclusion, while chronic hives and controlled hypertension do not automatically disqualify someone from receiving the COVID-19 vaccine, a thorough consultation with a healthcare provider is essential to ensure safety and address any concerns regarding his health status and vaccination.

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