PSAAI

Guidance on the Prevention, Diagnosis and Management of

Immediate Severe Allergic Reactions to COVID-19 Vaccines


February 9, 2021



This document and algorithm were developed by the Working Group on Anaphylaxis
of the Philippine Society of Allergy, Asthma & Immunology (PSAAI).


Working Group members:


Julia C. de Leon, MD, Gwyneth Bautista-Velez, MD, Maria Carmen D. Ang, MD,
Caroline C. Aquino, MD, Regina D. Capulong, MD, Mary Anne R. Castor, MD,
Aileen A. Elorde, MD, Caroline A. Tolosa-Gloria, MD, Roxanne Casis Hao, MD,
Aimee Lou M. Nano, MD, Irene Ngo-Liu, MD, Mary Ann Jean T. Patrimonio, MD,
Fatima Johanna T. Santos-Ocampo, MD, Felicia Racquel S. Tayag, MD, Marysia T. Recto, MD
INTRODUCTION

The COVID-19 pandemic has been the biggest global health challenge the world has faced. Globally, there are
more than 100 million reported cases with the death toll exceeding 2 million. In the Philippines, we have gone
beyond the 500,000 mark, leading to a major health and socio-economic crisis.

Scientists around the world have been working to develop, test and produce vaccines to address the spread
and decrease the mortality and morbidity of COVID-19. Several vaccines have already been rolled out in some
parts of the world. The Philippines has its own National COVID-19 Vaccination Program which is scheduled to
roll out before the end of the first quarter of 2021.

The first part of the document aims to present a model to stratify the risk for severe allergic reactions of
persons BEFORE receiving the COVID 19 vaccine based on their past medical and allergy history. Although any
person may develop an allergic reaction to a vaccine, based on current evidence, this model will define groups
of persons who will benefit from further evaluation prior to COVID 19 vaccination. This document and
algorithm was adapted from the 2021 statement of the European Academy of Allergy and Clinical Immunology1
on severe allergic reactions to COVID 19 vaccines and the German recommendations for allergy risk
assessment2.

The second part is an algorithm that enumerates the signs and symptoms of immediate allergic reactions.
Immediate medical and supportive management is described in a stepwise manner followed by
recommendations for disposition and further evaluation for future vaccination recommendations. Emergency
medications, supplies and equipment, as well as prompt recognition by trained emergency response personnel
are vital in the safe administration of the COVID 19 vaccines.

References:

1 Sokolowska M, et al. EAACI statement on the diagnosis, management and prevention of severe allergic
reactions to COVID-19 vaccines. Allergy. 2021 Jan 16.
2 Worm M, et al. Practical recommendations for the allergological risk assessment of the COVID-19

vaccination - a harmonized statement of allergy centers in Germany. Allergol Select. 2021 Jan 26;5:72-76.