Food Allergy Awareness Week: Anaphylaxis Was a Thing Before Vaccines
Living with food allergies means the threat of anaphylaxis — a severe and life-threatening reaction — is always looming.
As the COVID vaccines began rolling out, reports of anaphylaxis rolled in. Friends and family texted and called to let me know and ask if I still planned to get the shot. After consultation with my doctor and with a prophylaxis regimen on hand, I got my first shot 4 weeks ago without an allergic reaction and am scheduled for my second dose tomorrow.
But the prevalence of anaphylaxis in the news got me thinking. Anaphylactic reactions to the vaccines are rare: 1.31 per 1 million doses. Anaphylaxis more generally occurs in about 1 in 50 Americans. And yet, there are very few headlines about these reactions, limited panic about food allergies, and very little understanding by the non-allergic population as to how severe a food allergy can be.
Maybe it’s because the vaccines are new and there’s a lot of division and misinformation about vaccines in general and COVID specifically. As such, life-threatening reactions grabbed headlines; it’s great clickbait! But to those of us who have experienced anaphylaxis — maybe even more than once — this was not the attention we hoped for. After reporting on the rare reactions, media outlets pivoted to downplay the concern. The patients all recovered. They all had Epi-pens. Get the vaccine. It’ll be fine.
This sends a mixed message about what anaphylaxis is and what it isn’t. So let’s get a few facts straight: anaphylaxis is a severe, immediate (usually within seconds, sometimes within a few hours), life-threatening allergic reaction. There are many symptoms, including airways closing, hives, swollen tongue or throat, trouble breathing, weak and rapid pulse, nausea, dizziness, and an impending sense of doom. It’s not always the same. Anaphylaxis should be treated by epinephrine as soon as possible — any lag time can lead to death.
Contrary to what you see on TV, a jab of epi into a thigh doesn’t spring a person back to normal. Yes, the reaction calms down, but not necessarily long-term. Anaphylaxis can recur even after an epinephrine injection, so it’s really important for people with allergies to carry at least 2 epinephrine auto-injectors and get to an ER right away for further monitoring. While epi is enough to revive the person experiencing anaphylaxis, other treatments may be necessary, too, like steroids, antihistamines, supplemental oxygen, and antacids. The reaction can linger for days — I’ve had reactions persist for a week, and because I have multiple allergic triggers, when my body is mid-reaction, it tends to overreact to everything else, even making certain allergens airborne.
Anaphylaxis is AWFUL. It feels like you’re about to die, and that’s because you are, unless you get help stat. It takes time to recover from the shock to your system and the medicines come with side effects. Epinephrine makes me shake uncontrollably. Steroids give me tremendous mood swings, cravings, full-body soreness, inability to sleep, complete exhaustion, and weight gain. I’ll accept every. single. one. of these side effects if it means I get to live.
That’s how I felt about the COVID vaccine, too — I want to be protected from the disease, and I believe in the safety and efficacy of the vaccine. I understand my personal risks and am prepared. When I received my first dose, I walked the nurse through my allergic history, showed her where my Auvi-Q epinephrine auto-injectors were, and asked for additional monitoring. It was scary. But it also felt like my likelihood of an anaphylactic reaction to the vaccine was less than if I ate out in a new restaurant, and safer, since everyone around me was aware and prepared.
As the vaccine headlines wane and the general public’s fear about anaphylaxis dissipates, remember that people with food allergies risk anaphylaxis every day, simply by daring to eat. Keep us in mind, even when we’re not newsworthy — awareness and epinephrine are what keeps us alive.