GPs can now offer Covid vaccines to patients with history of anaphylaxis

GPs can now deliver Covid vaccinations to patients with a history of anaphylaxis, NHS England has said.

Last month, GPs were told not to give the Pfizer vaccine to patients with a history of ‘significant’ allergic reaction to a vaccine, medicine or food, following two incidents related to the vaccine.

But in an update to the vaccination programme’s standard operating procedures, NHS England said that these patients can now receive ‘any’ Covid vaccine as long as they are not allergic to any specific vaccine ingredients.

The document, updated yesterday, said: ‘A very small number of individuals have experienced anaphylaxis when vaccinated with the Pfizer BioNTech Covid-19 vaccine. 

‘Following close surveillance of the initial roll-out, the MHRA has advised that individuals with a history of anaphylaxis to food, an identified drug or vaccine, or an insect sting can receive any Covid-19 vaccine, as long as they are not known to be allergic to any component (excipient) of the vaccine.’

It added that ‘all recipients of the Covid-19 vaccine’ should be monitored for a ‘minimum’ of 15 minutes – in line with previous guidance – but did not seem to differentiate between the Pfizer and Oxford vaccines.

Those with a localised itchy skin reaction ‘without systemic symptoms’ to the first dose of the Covid vaccine should have a ‘prolonged observation’ of 30 minutes when receiving their second in a setting ‘with full resuscitation facilities’, such as a hospital, the document said.

It added that the British Society for Allergy and Clinical Immunology (BSACI) has advised that patients with a ‘history of immediate onset-anaphylaxis to multiple classes of drugs or an unexplained anaphylaxis’ should only be vaccinated with the Oxford vaccine. 

But those with non-allergic reactions to their first dose can receive the second dose ‘of any vaccine in any vaccination setting’, it said.

GPs previously told Pulse the lengthy anaphylaxis observation period would make it difficult for some sites to fulfil vaccine delivery requirements.

At least one GP network was forced to pull out of the programme because of the safety guidance, with PCNs around the country forced to urgently reconsider their plans.