As COVID-19 continues to spread throughout the United States and the world, physicians and doctors are hearing from their patients – those with allergies and especially those suffering from asthma. They are worried that having asthma means they’re at increased risk for developing symptoms from COVID-19 if they are exposed. They also wonder if their symptoms will be more dangerous if they have the virus. In addition, an announcement regarding a shortage of albuterol has increased anxiety throughout the country.
It is important if you have been diagnosed with COVID-19 or suspect you may have COVID-19 and are using a nebulizer at home, that you know the virus may persist in droplets in the air for 1-2 hours. Therefore, you should administer nebulized albuterol in a location that minimizes exposure to members of your household who aren’t infected. Choose a location for your treatment where air is not recirculated into the home – places like a porch or patio, or in a garage – areas where surfaces can be cleaned more easily or may not need cleaning.
The American College of Allergy, Asthma and Immunology Recommends:
- Continuing or resuming your asthma routine that helps you control your symptoms.
- Using short acting rescue medications as needed for symptoms.
- Following your asthma action plan if you have one.
- Following CDC guidelines regarding infection control, hygiene, social distancing, etc.
- If you have an upcoming appointment, please call to confirm. Many healthcare professionals are using telemedicine for return appointments.
- Contacting your healthcare team if you have questions about your medications or if your symptoms seem to be worsening or not under control.
What You Should Know about COVID-19 & Asthma
The U.S. Centers for Disease Control and Prevention has listed asthma as one of the chronic illnesses that may increase the chance of a severe case of COVID-19. So, here is what you need to know if you or a family member suffers from asthma.
- Respiratory viruses are the most common trigger for asthma exacerbations (severe worsening typically requiring oral steroids to relieve symptoms).
- Not all viruses affect asthma patients equally. Some viruses such as influenza and rhinovirus are more likely to trigger asthma flares than others.
- Right now, we don’t know if COVID-19 is one of those viruses that tends to trigger asthma exacerbation.
- There is no clear evidence that patients with asthma are at any higher risk of contracting COVID-19.
- Asthma is an “underlying medical condition” that may be associated with more severe disease if you are infected with COVID-19.
- There is no evidence that asthma medications used to prevent symptoms (inhaled steroids, oral steroids, montelukast, biologics), etc. increase your risk of contracting COVID-19.
- If you become infected, use caution and avoid experimental treatments unless the treatment is specifically recommended by the physician caring for you.
Guidance on risk of allergic reactions to mRNA COVID-19 vaccines
Following reports of some patients experiencing anaphylaxis after getting a COVID-19 vaccine, the CDC has issued guidance related to COVID-19 vaccines and severe allergic reactions. Specifically, the CDC recommends patients experiencing a severe allergic reaction after getting the first shot should not get the second shot. The CDC also says that doctors may refer these patients to a specialist in allergies and immunology to provide more care or advice.
Reactions to vaccines, in general, are rare, with the incidence of anaphylaxis estimated at 1.31 in 1 million doses given. With the FDA emergency use authorization of the Pfizer-BioNTech COVID-19 vaccine on December 11, 2020 and the Moderna vaccine on December 18, 2020, the ACAAI COVID-19 Vaccine Task Force recommends the following guidance for physicians and other providers related to risk of an allergic reaction on vaccination.
These recommendations are based on best knowledge to date but could change at any time, pending new information and further guidance from the FDA or CDC.
- The mRNA COVID-19 vaccines should be administered in a health care setting where anaphylaxis can be treated. All individuals must be observed for at least 15-30 minutes after injection to monitor for any adverse reaction. All anaphylactic reactions should be managed immediately with epinephrine as the first line treatment.
- The CDC has issued guidance on COVID-19 vaccines and severe allergic reactions. According to the CDC, if you have a severe allergic reaction after getting the first shot, you should not get the second shot. Additionally, the CDC notes patients who experience a severe allergic reaction may be referred by their doctor to a specialist in allergies and immunology to provide more care or advice.
- The mRNA COVID-19 vaccines should not be administered to individuals with a known history of a severe allergic reaction to any component of the vaccine. Although the specific vaccine component causing the anaphylaxis has not been identified, polyethylene glycol is one of its ingredients and has been known to cause anaphylaxis.
- Data related to risk in individuals with a history of allergic reactions to previous vaccinations and/or mast cell activation syndrome/idiopathic anaphylaxis is very limited and evolving. A decision to receive either of the mRNA COVID-19 vaccines should be undertaken by you with your physician or other provider administering the vaccine using their professional judgment balancing the benefits and risks associated with taking the vaccine.
- People with common allergies to medications, foods, inhalants, insects and latex are no more likely than the general public to have an allergic reaction to the mRNA COVID-19 vaccines. Those patients should be informed of the benefits of the vaccine versus its risks.
- The mRNA COVID-19 vaccines are not live vaccines and can be administered to immunocompromised patients. Physicians and other providers should inform such immunocompromised patients of the possibility of a diminished immune response to the vaccines.
- If you have questions related to the risk of an allergic reaction to either of the mRNA COVID-19 vaccines, contact your local board-certified allergist/immunologist.
How to Tell the Difference between COVID-19, Asthma, & Nasal Allergies
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Disclaimer: This article is based on the most current information available at the time of publication; however, recommendations regarding public safety and practice may change rapidly during the COVID-19 pandemic. Individuals can get up-to-date information on COVID-19 from the CDC website, CDC.gov.
The American College of Allergy, Asthma and Immunology are continuously updating their website with COVID-19 resources for people with allergies and asthma. Visit education.acaai.org/coronavirus for more information.
Source: American College of Allergy, Asthma & Immunology, acaai.org