Why pollen makes you sneeze

Following is the transcript of the video.

Narrator: When trees, weeds, and grasses mate, they make a mess. Thousands of pollen grains – their reproductive material – fly into the air. And anyone with allergies knows not to get too close, or else. But what is it about that fluffy stuff that sets off the summer sneezes, anyway?

Each year, 26 million Americans experience an allergic reaction sometimes nicknamed hay fever. The culprit? Pollen. And to help them get to where they need to go, the pollen grains are extremely light and sticky. The wind can carry them for thousands of kilometers across state lines and over mountains.

You can even find pollen over 600 kilometers out to sea, with no trees in sight. In other words, this sticky stuff gets everywhere. And sometimes it sticks to places it shouldn’t. Like your clothes, car, and especially your eyes, nose, and lungs. That’s when the trouble starts.

But here’s the odd thing about pollen. On its own, it’s harmless. It’s not a virus or parasite that can give you a disease or damage your organs. It only becomes a problem when your body sees it as one.

Dr. Todd Mahr: “Our body reacts to that antigen-basically the protein in the pollen, and for some reason our body recognizes it as foreign.”

Your immune system has a merciless procedure for dealing with intruders. The first line of defense are Y-shaped proteins called antibodies. They’re like a built-in security system that guards your nose, eyes, and mouth, along with other tissues. When they bump into a grain of pollen, they sound the alarm.

Now, their main goal is to get that pollen out of your system. Which they do by sending a rush of white blood cells to the scene which then produce a chemical called histamine. Histamine has a few ways to get the job done: First, it irritates your nose, forcing you to sneeze.

Which blasts some of the pollen away! Second, it expands your blood vessels, opening tiny gaps between the cells that make up the wall. Opening the path for a squadron of immune cells to squeeze out and attack the pollen grains.

Finally, it tells your nose to make more mucus! Which traps the invader and flushes it out of your nasal passages. Mission accomplished. Histamine also flushes out your eyes in a similar way. It irritates your eyes, causing them to swell and tear up. And if pollen reaches your lungs, histamine irritates the lining, causing you to cough it out.

The end result? You’re a snotty, miserable mess. And since different plants reproduce at different times in the spring and summer, the assault can last for months. But, hey, at least your system is pollen-free. Now, pollen isn’t the only irritant that can cause this type of reaction.

Dr. Todd Mahr: “People react to foods, they react to pollens, they react to chemicals, they react to antibiotics, they react to bee stings. All of those are the same type of immune reaction.”

However, pollen is one of the most common allergies, but scientists aren’t entirely sure why. What they do know is that some people have more sensitive immune systems than others. And that’s based on a bunch of factors, like genetics, when you were first exposed to pollen, and how much of it you were exposed to.

Dr. Todd Mahr: “All of that influences what your body’s going to do and what kind of reaction it’s going to have.”

Regardless of how you ended up with allergies, one thing’s clear: THEY SUCK.

Dr. Todd Mahr: “You’re going to be really miserable. And some people are very, very uncomfortable, and it leads to lost work, to lost school.”

Seasonal allergies cost the US $18 billion a year in lost work hours and medical bills. And there’s bad news: Climate change is making them even worse. A recent series of studies showed that over the past 20 years as global temperatures have climbed, pollen counts have risen with them.

Plus, the earlier and longer periods of warm weather have stretched prime pollen season longer than ever.

Dr. Todd Mahr: “If it’s warmer, which is what climate change is doing, you’re going to have more of those pollinating species thriving.”

The good news is, there are ways to keep the summer sneezes at bay. Like antihistamines. These meds grab on to those irritating histamine molecules, preventing them from working. Hence the name ANTI-histamine.

So as the skies cloud with yellow horror dust, and pollen counts skyrocket, grab a tissue, pop an antihistamine, and hope that winter returns soon.

EDITOR’S NOTE: This video was originally published in August 2019.

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How to know if you’re allergic to the COVID-19 vaccines by Moderna, Pfizer, or J&J

children covid-19 vaccine
  • Most people with severe allergies will not react to a COVID-19 vaccination.
  • None of the shots from Moderna, Pfizer, and J&J contain preservatives. They have no eggs or latex in them.
  • But they do include some other fatty substances, which, in rare cases, people can react to.
  • See more stories on Insider’s business page.

More than 44 million people across the US have been fully vaccinated against COVID-19 – that’s about 13% of the country.

Just a very small fraction of those people, about 0.00045%, have had an allergic reaction. Their symptoms ranged from localized hives to wheezing or even life-threatening anaphylaxis.

“Fortunately, I’m not aware of anybody actually dying from getting the vaccine,” Dr. Sanjeev Jain, a board-certified allergist, immunologist, and CEO of Columbia Allergy, told Insider.

Culprits at work in the three authorized vaccines, allergy-wise, seem to stem from a couple of ingredients: polyethylene glycol (PEG), and polysorbate. These are common additives, which help many products better maintain their moisture and stick together in a uniform way.

In the drug industry, these substances can be used to deliver fragile vaccines and medications in convenient formulations. They’re also used in many other ways to make things run smoother, and can be found in everything from processed foods to colonoscopy prep solutions and face creams.

PEG and polysorbate are key ingredients in the COVID-19 vaccines authorized for use in the US (both Pfizer and Moderna’s shots include PEG, while Johnson & Johnson’s shot has polysorbate in it).

But Dr. Jain says, even if you do have an allergy to one of those vaccine ingredients, there are still ways to get vaccinated safely. In fact, if you’ve ever used a laxative, you may already have a pretty good indication of your risk.

What are the reactive ingredients in the COVID-19 vaccines by Pfizer, Moderna, and J&J?

While some people may want to pore over the ingredients listed in each vaccine, it’s important for people with severe allergies to also have a basic understanding of what’s not in any of these vaccines.

There are no preservatives, no eggs, and no latex. The ingredients to focus on are PEG and polysorbate.

Pfizer vial
Pfizer and Moderna’s vaccines have PEG inside, while J&J’s has polysorbate.

Pfizer and Moderna’s vaccines are extremely similar and both contain PEG.

The shots are messenger RNA-based (mRNA), and include a combination of fats, salts, sugar and acids, to carry the vaccine’s critical genetic instruction manuals into the body, to teach it to fight off the coronavirus. Polyethylene glycol (PEG) is one of the fatty substances (or, lipids) included in both vaccines to help stabilize and package the key ingredients.

J&J’s shot is different.

It works by injecting viral DNA into a person’s arm, not mRNA. Instead of PEG, it has polysorbate in it.

But that doesn’t mean J&J’s vaccine is necessarily a better option for people with severe PEG allergies. The CDC stresses there is “cross-reactive hypersensitivity” between PEG and polysorbate, meaning that someone who’s allergic to one substance could also react to the other.

“Polysorbate is a very similar chemical to polyethylene glycol,” Jain said. “So, there is a good chance that if somebody is allergic to polyethylene glycol, they’re going to be allergic to polysorbate as well.”

People with PEG allergies may tolerate J&J’s shot a little better

afghanistan covid-19 vaccine
An Afghan health worker receives a dose of COVID-19 vaccine at a medical center in Herat, Afghanistan, March 17, 2021.

The US Food and Drug Administration (FDA) is not recommending that anyone with allergies avoid COVID-19 vaccination, categorically.

But, the CDC says that you should avoid any particular vaccine that contains an ingredient you are allergic to (such as PEG or polysorbate).

That’s why Pat Wyman, CEO of HowtoLearn.com (a website focused on teaching people how to improve their learning and recall skills) waited until J&J’s shot was available at her local pharmacy in order to get vaccinated.

Wyman is allergic to PEG, and even a little bit of it included in a face cream can give her a headache.

“I’ve had so many allergic reactions to medications,” she told Insider, adding that she always carries around two EpiPens in her purse, just in case of an attack.

Her doctor recommended that she find a place offering J&J’s single-dose vaccine, and Wyman did, at her local pharmacy, on March 10.

“We still have to exercise caution, but it makes me happier that I did it,” she said of being vaccinated.

After vaccination, Wyman did have some severe vaccine side effects, including a high fever, chills, and a headache that began “two seconds” after vaccination she said, and lasted for five days. She thinks that’s probably related to the vaccine’s polysorbate component.

Still, as an immunocompromised person, she knows the risk of catching COVID-19 far overshadows that “temporary discomfort” of getting vaccinated.

“I would do it again in a heartbeat, because it is so important for me to feel safer in general,” she said. “More than that, I want to be able to spend quality time with my family and be able to hug my children, and my grandchildren, and travel!”

Allergists are using laxatives to find out if patients have sensitivity to the COVID-19 vaccines

china covid-19 vaccine
A man receives the COVID-19 vaccine at a gymnasium on March 18, 2021 in Beijing, China.

There are ways to find out if you might have an allergic reaction to a COVID-19 vaccine beforehand.

One good indication that you may be at risk, Jain said, is if you’ve already reacted to a previous vaccination (like the flu vaccine). If that’s the case, consult an allergist before you get vaccinated.

If you are severely allergic to a particular vaccine’s ingredients, your doctor may still be able to recommend a treatment that will make it safe to take the vaccine, though it is time-intensive.

“What a lot of allergists are doing now is systematically testing people for possible polyethylene glycol allergy,” Jain said.

One way to do that in relative safety is for an allergist to administer their patient a bit of Miralax, a laxative that includes PEG. Then, the patient might start to feel nauseous or get a headache – red flags that they probably are sensitive to PEG.

After that screening, those people may choose to undergo desensitization. Jain’s practice has desensitized several people to PEG after they had a reaction to their first dose of Pfizer or Moderna’s vaccines.

The desensitization process involves two six-hour sessions, where patients are administered PEG in tiny, incremental doses, using an IV. Dr. Jain starts with a dose of .1 mg of PEG and increases the dosage every 20 minutes.

Patients must get their second dose of mRNA vaccine within 24 hours of their second IV session, as PEG stays in the body for a full day, and patients won’t have a reaction during that time.

What to do before your vaccine appointment if you’re nervous about having a reaction

FILE - In this July 8, 2016, file photo, a pharmacist holds a package of EpiPens epinephrine auto-injector, a Mylan product, in Sacramento, Calif. On Tuesday, March 24, 2020, the U.S. Food and Drug Administration warned the public about malfunctions involving some EpiPens, the emergency injectors for severe allergic reactions. (AP Photo/Rich Pedroncelli, File)
A package of EpiPens.

Before going in for vaccination, people who are concerned about their potential for allergic reaction to COVID-19 vaccines may choose to take an antihistamine, like Zyrtec or Benadryl. Taking an antihistamine if you have mild symptoms after the shot is also fine, Jain said (though, if you’re having any trouble breathing, seek clinical care).

Vaccination sites are also required to have epinephrine for allergic reactions on hand, but talk to your vaccinator to confirm that’s the case, and let them know more about your specific allergy history. Then, make sure to stick around for a full 30 minute observation period after vaccination.

Take comfort when you leave the vaccine site then, knowing that almost all allergic reactions occur in the 15 minutes after vaccine administration.

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Only 10 people who’ve gotten Moderna’s COVID-19 vaccine have had severe allergic reactions – and more than 4 million doses have been given out

moderna vaccine
Moderna’s COVID-19 vaccine is one of two that have been authorized for emergency use to fight the pandemic across the US. The other vaccine available is from Pfizer.

  • Very few people have had confirmed, allergic reactions after being vaccinated.
  • New CDC data released Friday shows that just 10 people who’ve gotten Moderna’s vaccine in the US have had severe (anaphylactic) allergic reactions, among more than 4 million shots delivered. 
  • The CDC recommends that people who do have an allergic reaction to a first dose of COVID-19 vaccine should not get their second shot.
  • Visit Business Insider’s homepage for more stories.

The odds of having a severe allergic reaction after receiving Moderna’s COVID-19 vaccine are looking incredibly slim.

On Friday the Centers for Disease Control and Prevention released its first comprehensive trove of data detailing how many people have had confirmed allergic reactions after getting Moderna’s new shot.

Among more than 4 million doses of the vaccine that were administered nationwide from December 21 to January 10, just 10 people reported confirmed cases of anaphylaxis after vaccination, which is a severe allergic reaction requiring administration of epinephrine.

An additional 43 vaccine-takers had less severe nonanaphylactic allergic reactions, with symptoms including itching (especially in the mouth and throat), rashes, and “sensations of throat closure.”

There have been no reports of death so far, and patients have generally recovered well after these allergic reactions, though five of the 10 severe cases had to be admitted to intensive care first. (Pfizer’s new COVID-19 vaccine, too, has been very rarely associated with allergic reactions.)

10 women have had severe, allergic reactions to the Moderna vaccine

moderna vaccine distribution
The first day of Moderna COVID-19 vaccinations in Broadbent Arena at the Kentucky State Fair and Exposition Center on January 4, 2021 in Louisville, Kentucky.

All of the confirmed cases of anaphylaxis after administration of Moderna’s shot so far were in women, which isn’t a huge surprise when you consider that most of the non-elderly people who’ve been vaccinated so far are healthcare workers, an industry which is 76% female.

In addition, according to CDC data, more than 2.4 million woman have gotten Moderna’s shot, compared with 1.4 million men (an additional 125,000-plus people who got Moderna shots didn’t record a sex.)

Most of the anaphylactic reactions happened within just minutes of vaccination. Only one of the ten cases took longer than 30 minutes to present, post-vaccination: 

CDC MMWR Moderna allergies

For these reasons, the CDC is recommending that all vaccine sites have doses of epinephrine on hand, and that people who get vaccinated should wait 30 minutes at the vaccine site before heading off, just in case something happens.

“It’s important that anybody who has had anaphylaxis talk to their vaccinator about that, and make sure that if they choose to be vaccinated, they wait the 30 minutes,” Dr. Thomas Clark, who’s been tracking allergic reactions after vaccination at the CDC, told reporters earlier this month.

Nine of the 10 patients who had severe, allergic reactions after Moderna’s shot had a history of allergies, and the most common allergies among them were to drugs (six patients). Just one patient with a severe reaction after vaccination had a food allergy.

“You know, many, many people with histories of allergies were vaccinated uneventfully,” Dr. Clark added.

People who do have an allergic reaction after their first shot of Moderna or Pfizer’s vaccine should not get their second dose, the CDC says. 

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Most people with allergies should get Pfizer’s coronavirus shot, according to the FDA

covid vaccine trial
Lisa Taylor receives a COVID-19 vaccination during a clinical trial.

  • The newly authorized Pfizer coronavirus vaccine appears to be safe for people with food or environmental allergies, the FDA said on Saturday.
  • Two people in the UK reported severe allergic reactions after getting the shot.
  • After careful consideration, the FDA decided not to include warnings against the vaccine for people with a history of severe allergies, since that’s a large segment of the population and such complications didn’t occur in clinical trials. 
  • Still, there’s more to learn, and all vaccine distribution sites will be equipped to treat any allergic reactions that may occur, which the FDA will continue to closely monitor. 

People with common allergies to foods or to things in the environment like pollen or dust probably don’t have to worry about having a serious reaction to the just-authorized Pfizer coronavirus vaccine, the US Food and Drug Administration said during a press conference on Saturday. 

Even people who’ve had a severe allergic reaction to food or to something in the environment in the past should be OK to get the shot, Dr. Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said during the briefing. FDA said that people who are allergic to the shot itself or to one of its ingredients shouldn’t get it.

“We’re telling people that unless they’ve had a severe allergic reaction to the vaccine or one of its components, they can receive it,” Marks said. 

FDA held the briefing to provide more information on Pfizer’s coronavirus vaccine, after clearing the shot late Friday for emergency use in people 16 and older. In authorizing the vaccine, the FDA said it’s generally safe and highly effective at preventing symptomatic cases of COVID-19, the disease caused by the new coronavirus.

The clarification for people with allergies came after two people in the UK with known, severe allergies had non life-threatening anaphylactic reactions soon after being injected with the vaccine. UK health officials said that people with a history of severe, or anaphylactic, reactions to vaccines, medicines, or food should not get the shot.

“I just want to reassure the public that, although there were these few reactions in Great Britain, these we’re not seeing in the larger clinical trial data sets,” Marks said.

The trial included people with common issues like asthma and food allergies, but excluded people with severe allergies to vaccines.

Allergies are common, but serious reactions to this vaccine are not  

About 30% of the global population has seasonal allergies, 10% have drug allergies, and 8% of children worldwide have food allergies, according to the American Academy of Allergy, Asthma, and Immunology. In the US, 1 in 10 adults has food allergies, Food Allergy Research and Education reports. 

Marks said that 1.6% of the population has had a severe allergic reaction to a food or something in the environment. 

“We would really not like to have that many people not be able to receive the vaccine,” he said.  

That’s why, after careful consideration, the agency decided not to include a warning about allergic reactions, outside of those to the vaccine itself and its components, in its fact sheets. 

Still, all vaccination sites will have EpiPens, Benadryl, and hydrocortisone on hand to treat any potential reactions that pop up, which the agency will track. 

“We have very good safety surveillance systems in place in conjunction with the Centers for Disease Control and Prevention, and we may have to modify things as we move forward,” Marks said. “But for right now, we’re comfortable with this [advice], and the extra piece of this is that centers will have the ability to treat allergic reactions.”

Most of the components in the Pfizer shots are benign 

Marks said people with a history of allergic reactions should still talk to their doctor, who can help them figure out if they may be allergic to one of the components in the new vaccine, including lipids, potassium, chlorine, salt, and sugar. A full list of the components is available here

“None of those ingredients appear to be highly allergenic,” Dr. Sanjeev Jain, a board-certified allergist, immunologist, and CEO of Columbia Allergy told Business Insider’s Hilary Brueck, stressing that most of the chemicals in the new shot are quite benign. 

He said there could be a few explanations, then, for why the two people in Britain experienced severe reactions. In rare cases, people can react to polyethylene glycol, a component of one of the ingredients.  

It’s also possible the people had “non-specific” mast cell reactions, or that something about the vaccine particles triggered the body’s response to allergens. 

Finally, the two people with reactions could have recently had an allergy treatment or come in contact with another allergen, which, in combination with the effect of a vaccine on the immune system, “sent it into overdrive,” Brueck reported. 

“The fact that their immune system got stimulated by the vaccine, that could have triggered a reaction,” Jain said.

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