Allergy, Asthma & Immunology Center for Adults and Children


Srividya Sridhara, MD

Sasha Alvarado, DO


Contact :  972-521-3366

                                COVID-19 and Vaccination FAQs

 
What causes COVID-19 illness?

  • COVID-19 (coronavirus disease 2019) is caused by a virus which was discovered to infect humans in 2019.
  • SARS-CoV-2 is the name of the virus which causes COVID-19 illness.
  • SARS-CoV-2 spreads mainly through inhalation into the nose, mouth, and airways(*1).​


Can I be tested for COVID-19 at Allergy, Asthma & Immunology Center?

  • No.  In order to continue to serve our patients safely and effectively, we want to minimize exposure to infection among our patients and staff. 
  • Please inform us before your appointment if you have come in contact with anyone under investigation for COVID-19 infection.
  • Inform us before your appointment if you have had fever, cough, trouble breathing, or any unusual symptoms in the last 14 days.
  • To limit your exposure to others, you may be asked to wait in your car and/or conduct the interview portion of your appointment by phone or televisit.
  • Always wear a mask or face-covering within the office.​


What vaccines are available for COVID-19?


  • In the United States, available COVID-19 vaccines include:
    1. Pfizer-BioNTech mRNA vaccine
    2. Moderna mRNA vaccine
    3. Janssen (Johnson & Johnson) viral vector vaccine
    Check for updates from the CDC at https://www.cdc.gov/vaccines/covid-19/info-by-product/index.html.


Can my child be vaccinated?

  • Pfizer-BioNTech COVID-19 Vaccine is recommended for individuals age 12 years and older.  (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Pfizer-BioNTech.html)
  • Moderna vaccine is currently recommended for individuals age 18 years and older.  (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html)
  • J&J/Janssen COVID-19 Vaccine is recommended for people aged 18 years and older.  (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/janssen.html)


How do the mRNA vaccines work?

  • COVID-19 mRNA vaccines give instructions for our cells to make a harmless piece of what is called the “spike protein.” The spike protein (in red) is found on the surface of the virus that causes COVID-19.
  • mRNA technology is new, but not unknown. They have been studied for more than a decade.
  • mRNA vaccines do not contain a live virus and do not carry a risk of causing disease in the vaccinated person.
  • mRNA from the vaccine never enters the nucleus of the cell and does not affect or interact with a person’s DNA(*5)


How do we know that mRNA vaccines are safe?

  • COVID-19 vaccines were tested in large clinical trials to make sure they meet safety standards. Many people were recruited to participate in these trials to see how the vaccines offers protection to people of different ages, races, and ethnicities, as well as those with different medical conditions.  These trials were able to be completed faster than other vaccine trials because of how quickly COVID-19 spreads. 
  • The Food and Drug Administration (FDA) carefully reviews all safety data from clinical trials and authorizes emergency vaccine use only when the expected benefits outweigh potential risks.
  • The Advisory Committee on Immunization Practices (ACIP) reviews all safety data before recommending any COVID-19 vaccine for use.
  • FDA and CDC will continue to monitor the safety of COVID-19 vaccines, to make sure even very rare side effects are identified.
  • The findings of these organizations are always publicly available on their websites. 

                 

What are the benefits of mRNA vaccines compared to traditional vaccines?

  • Short manufacturing times.
  • They do not contain live virus and do not carry a risk of causing disease in the vaccinated person (*5)

​​

Should I be vaccinated if I have an immune deficiency?

  • Vaccination is expected to be beneficial for patients with immune deficiencies.  Even patients with deficiencies in antibody production may develop different types of protective immune responses(*6).


How effective are the vaccines?

  • Both the Pfizer and Moderna vaccines are about 95% effective after 2 doses, which is very good(*7) 
  • For comparison: 2 doses of MMR vaccine are 97% effective against measles and 88% effective against mumps(*8).  The annual influenza vaccine is usually about 40-60% effective(*9).
  • Effectiveness is measured by whether being vaccinated protects you from getting sick.  We do NOT know whether being vaccinated stops you from spreading the disease to other people.  Therefore, it is important that you continue to mask, wash hands frequently, and physically distance to protect your community. 


​​What are side effects of the COVID-19 vaccine?

  • Symptoms are usually mild to moderate and resolve within 1-3 days.
  • The most common symptoms are pain at injection site, fatigue, headache, muscle pain, joint pain, chills, nausea, swelling and tenderness of the vaccination arm, fever, and injection site redness.
  • These symptoms are signs of your immune system responding and are not cause for concern.  
  • You can call us or send a portal message (health.healow.com/aaictx) if you experience anything unusual or need non-emergent advice.  


Have there been allergic reactions to the vaccines?

  • Anaphylaxis has been reported in people who received the vaccine.  Everyone is required to be monitored for at least 15 minutes after vaccination to monitor for reactions. 
  • If you have a history of anaphylaxis from ANY cause in past, a 30-minute observation is recommended.
  • Taking antihistamines before vaccination is NOT recommended (*10).


What is anaphylaxis?

  • Anaphylaxis is a severe allergic reaction in which your immune system releases chemicals which affect multiple organ systems (such as skin, lungs, stomach, etc.)  Symptoms usually occur within minutes to an hour of exposure to the allergen but can occur up to 4-6 hours later in very rare cases.
  • Symptoms of anaphylaxis can vary widely, but can include itching, rash, flushing, swelling, lightheadedness, shortness of breath, wheezing, nausea, abdominal cramps, diarrhea, low blood pressure, and loss of consciousness. 
  • If you have ever experienced anaphylaxis, you should be evaluated by a board-certified allergist. 


Who should not receive a COVID-19 vaccine?

Evaluation by an allergist-immunologist is recommended before vaccination in patients with any of the following(*11):

  • severe allergic reaction (e.g., anaphylaxis) after a previous dose of an mRNA COVID-19 vaccine or any of its components
  • immediate allergic reaction of any severity to a previous dose of an mRNA COVID-19 vaccine or any of its components (including polyethylene glycol [PEG])*
  • immediate allergic reaction of any severity to polysorbate (due to potential cross-reactive hypersensitivity with the vaccine ingredient PEG)*


Which risk category am I in, and when can I get a vaccine?

  • We recommend checking the State Health department website (https://www.dshs.state.tx.us/coronavirus/immunize/vaccine.aspx) for the most updated information about which phase the community is in and where you fit. 
  • Note that allergic rhinitis and asthma are not chronic conditions which put you at risk for severe COVID-19 illness.  COPD is a high-risk condition(*12).  


Can I get an allergy shot on the same day as the COVID-19 vaccine?

  • We do not believe these injections interfere with each other.  However, because of the potential for reaction to either injection, we recommend spacing apart by at least 3 days.  This will minimize confusion about any reactions you may experience. 


If I already had COVID-19 infection, or if I received antibodies for treatment, do I still need the vaccine?

  • CDC recommends vaccination regardless of whether you have been sick with COVID-19 in the past.   You may obtain the vaccine as soon as you are no longer sick nor isolating.  However, because reinfection is uncommon in the 90 days after initial infection, you may consider delaying vaccination until near the end of this period.
  • Passive antibody therapy can decrease your vaccine response.  If you were treated with antibodies for the COVID-19 infection, the CDC recommends waiting at least 90 days before vaccination(*13)


I have an immune deficiency. Will my body develop a good immune response from the vaccine?

  • You will likely develop an immune response, but we do not know to what degree. It is still recommended you receive the COVID-19 vaccine to maximize protection.
  • Family members and close contacts should receive the vaccine so there is less likelihood of viral spreading.
  • Since treatment immune globulin (subcutaneous or intravenous forms) has a shelf-life of several years, it is unlikely patients will be receiving any COVID-19 antibodies in SCIG or IVIG infusions in the near future.


Will Allergy, Asthma & Immunology Center administer the COVID-19 vaccine?

  • We plan to offer vaccine days at our Murphy location if we are allocated doses by the state health department. 


Sources:

  1. https://www.cdc.gov/coronavirus/2019-ncov/faq.html
  2. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines.html
  3. https://www.cdc.gov/vaccines/covid-19/info-by-product/pfizer/index.html
  4. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/Moderna.html
  5. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/different-vaccines/mrna.html
  6. https://primaryimmune.org/news/covid-vaccine-video-update
  7. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
  8. https://www.cdc.gov/vaccines/vpd/mmr/public/index.html
  9. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm
  10. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/managing-anaphylaxis.html
  11. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html
  12. https://www.dshs.state.tx.us/coronavirus/immunize/vaccine.aspx
  13. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html#SARS-CoV-2-infection



Update On Doctor Visits


Considering the public health emergency situation in DFW area due to COVID-19 outbreak and the importance of social distancing the following guidelines are being implemented for doctor visits and existing allergy shot and biologic patient visits.

      These were developed based on the recommendations from American Academy of Allergy, Asthma and Immunology (AAAAI), CDC and in accordance with the rules of Texas Medical Board. Please note that we have many patients with immune-deficiencies, chronic lung conditions, and elderly patients who are at high risk if exposed to COVID-19 virus. 

                                                            

1.       For patients who may have been exposed to COVID19 coronavirus (air travel within the last 14 days or exposure to someone under investigation or diagnosed with coronavirus) and have fever over 100.4, body aches, fatigue, cough, shortness of breath, cold like symptoms should call their PCP or go to the ER. Please call the ER before you go in, so they are prepared.  There is no testing available for coronavirus in our clinic and please do not come in.

2.       For patients who may have been exposed to coronavirus (air travel within the last 14 days or exposure to someone under investigation or diagnosed with coronavirus) and are not having any symptoms, please self-quarantine yourselves at home. This includes patients who are currently receiving allergy shots also. We will work with you on resuming shots on a safer dose at a safer time. Please seek immediate medical attention if you start becoming symptomatic.
 
3.       Please call us if you would like to reschedule your appointment at 972 521 3366.

4.       Avoid close contact and maintain a distance of at least 6 feet with other people even when they do not appear to be sick.

5.       Patients on allergy shots who have not had any likely exposure to COVID19 virus in the past 2 weeks can come in at this time for shots. Patient on allergy shots, please refer to another document under resources tab- pertaining specifically to allergy shot treatment continuation.

6.          We will be screening all patients coming in for routine appointments by phone prior to your appointment to make sure you are not in the at- risk group for COVID -19 at the time of your visit. We will do this screening once again upon check in. Based on your risk level, your appointment might be rescheduled to another convenient time. Where necessary appointments can be converted to tele-visits to minimize the risk of acquiring and spreading the infection. Please work with us for the safety of everyone. 

7.       Visits should be limited to the primary patient only and a caregiver if needed. Additional family members should remain at home or in the car to limit their exposure to illness in the clinic.

8.       All patients arriving in the clinic are requested to wear masks.  Patients are also encouraged to wear gloves or immediately clean their hands with hand cleanser and to do so again upon leaving the clinic.

9.   We are offering allergy testing and few other elective procedures at this time.

10.   We are wiping down exam rooms after each patient visit.  We are not encouraging hand shaking. Our staff will be wearing masks and gloves at all times. 

11. Please also note that we can be short staffed depending on the day care availability for the staff member’s children or depending on staff member’s health. Please work with us.

12. Please check with the Collin County Health Department (972-548-4707) for the latest updates on COVID-19 in DFW area at https://www.collincountytx.gov/healthcare_services/Pages/news.aspx .


 

                        Update on Allergy Shot and Biologic Visits

 

Note that our shot hours may be reduced or canceled based on the evolving situation.

Please check this site for latest hours before coming in. 

 
Please be reassured as always, we will work with you in continuing your allergy shot or biologic treatment in a safe and effective way. 

 
Please note that you are required to wear a mask when you come into the office to get your allergy shots/ biologic injections.

We also encourage you to wear gloves if you have or carry hand sanitizer so you can clean the hands right after you touch door knobs etc. 

Please call ahead – ideally 15 minutes before your arrival for an allergy injection.  That will allow us to check you in and prepare your allergy injection.   

If there are more than 4 people waiting, we will notify you of a possible wait time.

For those where there is a possible wait – please call from your car when you arrive, and we will tell you if it is a good time to come in. 

 At this time, we still encourage you to wait in your car after the shot for 30 minutes and return into the office for check out or any possible reaction. The pollen counts are high and there is higher risk for allergy shot reactions in spring.

Criteria to receive allergy shots-

1.Like always, it’s extremely important to receive your allergy shots only when you are feeling fully well


and

2. Not have had fever, body aches, fatigue, cough, shortness of breath, cold like symptoms, colored drainage,

and

3. Your allergy symptoms and asthma are under control

and

4. You should have taken an oral antihistamine at least 2 hours before coming in for allergy shot.

and

5. Not been exposed to someone under investigation or diagnosed with Corona virus within the past 2 weeks.

 
Thank you for your cooperation, stay safe!

Allergy Asthma & Immunology Center

Ph. (972)-521-3366