Table 1. Updated consensus statements (CS) on COVID-19 Vaccine Allergy Safety in Hong Kong*.
| CS #1: People with a history of immediate-type allergic reaction with systemic symptoms to prior COVID-19 vaccination should not receive further COVID-19 vaccination until allergist evaluation. |
| CS #2: People with a history of nonimmediate type allergic reaction to prior COVID-19 vaccination which required medical attention should seek allergist advice prior to further COVID-19 vaccination. |
| CS #3: People with a history of severe immediate-type allergy to multiple classes of drugs may have an undiagnosed excipient (such as polyethylene glycol [PEG]) allergy and they may be vaccinated with a non-PEG-containing vaccine†. |
| CS #4: Allergy testing with PEG or PEG-containing surrogates appear to be poorly predictive and should not be routinely performed. In cases where these tests are used, results should be interpreted in the context of a detailed clinical history by an allergist. |
| CS #5: Patients with allergic rhinitis, asthma, atopic dermatitis, chronic urticaria, drug and food allergies, and anaphylaxis unrelated to COVID-19 vaccines (without other precautions) do not need to see an allergist for evaluation of COVID-19 vaccine allergy risk. |
| CS #6: Healthcare providers should be sufficiently prepared to recognize and treat allergic reactions properly, with adrenaline and antihistamines readily available. |
| CS #7: When an immediate-type allergic reaction following COVID-19 vaccination is suspected, blood for serum tryptase should be saved from 30 minutes to 4 hours (preferably within 2 hours) of symptom onset. |
| CS #8: People should be routinely observed for at least 15 minutes after COVID-19 vaccination. Those at higher risk of COVID-19 vaccine-associated allergic reactions should be observed for at least 30 minutes after vaccination. |
| CS #9: Full excipient lists should be mandated and made available in all product inserts of registered drugs. |
COVID-19, coronavirus disease 2019.
*Individuals in other countries where multiple vaccines containing various excipients are available should follow advice from respective local authorities. †Individuals with strong preference to receive PEG-containing vaccines may consider referral to an allergist.