Table 4.

Guidelines by Swedish Association for Allergology 30 April 2021

The following guidelines apply for evaluation and routines at vaccination with the three approved vaccines Comirnaty (Pfizer) and COVID-19 Vaccine Moderna (Moderna) and COVID-19 Vaccine Vaxzevria (AstraZeneca)
For all vaccinations	Remain at least 15 min after vaccination. Preparedness for anaphylaxis in place
For those with a severe allergic reaction to allergens such as food, insect stings, latex, contrast media, local anaesthetics or per oral medication (e.g. antibiotics)	Remain at least 30 min after vaccination. In addition to preparedness for anaphylaxis, emergency treatment should be available, including oxygen and access to peripheral venous catheterization (e.g. at a primary care centre)
For those with a severe allergic reaction to vaccines or other injected medication, or previous repeated anaphylaxis reactions to medications: evaluate/consider whether the person can have reacted to PEG or PEG derivative such as polysorbate or polyoxyl 35, castor oil. If no hypersensitivity exists to PEG or PEG derivatives	Consider the risk–benefit estimate for vaccination against COVID-19. Vaccination should be done at the hospital or specialist clinic with access to advanced hospital care if needed (including anaesthesia preparedness). Individual assessment of time for observation postvaccination
For those with a severe allergic reaction to PEG/polysorbate or polyoxyl 35 castor oil	Consider vaccination with a vaccine that does not contain PEG or PEG derivatives
Patient with systemic mastocytosis	Vaccination should be done at the hospital or specialist clinic with access to more advanced care if needed (including anaesthesia preparedness). Individual assessment for observation time after vaccination
∗Severe allergic reaction relates to an adverse reaction in the patient's medical history that has required treatment at an emergency ward or hospitalization

PEG, polyethylene glycol.