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COVID Vaccination Allergy Pathway January 2022

Last Thursday’s CCG GP bulletin (30th December) contained the information re the long awaited allergy pathway replicated below for your information:

“This is an update on the CCG's Kent and Medway Covid Vaccination - Management of Allergies Policy, which launched in March 2021 . A copy of the policy (Version 12) is available here.

Recently, there has been some confusion around the allergy referral service provided by Guys’ and St Thomas’ Hospital (GSTT) to support the Kent and Medway vaccination programme. I can confirm the agreement with GSTT is still in place. Patients who require an allergy review with regards to their COVID-19 vaccination should continue to be referred to GSTT.

It is also important to note that while trusts across the country may not be able to physically see patients referred from Kent and Medway, they are obliged to consider Advice and Guidance (A&G) referrals. Guildford and Surrey NHS Trust has confirmed that they are happy to receive A&G referrals from Kent and Medway. This should be considered if it reduces patient waiting times.

Not all patients who experience adverse effects following their first dose of vaccine or who have a history of allergies require hospital setting vaccination and do not require a referral. The allergy service should not be used to mitigate against patient anxieties. Patients whose reactions occur two hours after vaccination should generally not be referred.

Please see the flowchart from the British Society for Allergy & Clinical Immunology which provides clear guidance on allergies and should be considered before referrals are made.

Summary of the GSTT Pathway:
The outcome of your A&G from GSTT should follow the GSTT pathway as follows;

  1. Allergy specialist responds to A&G saying safe for patient to be vaccinated in normal vaccination settings.
  2. Allergy specialist responds asking GP to convert A&G to a referral on e-RS

  • Allergy consultant happy with phone assessment; patient goes back to GP to ask for vaccination/advised to attend a local vaccination site.
  • Allergy consultant NOT happy with phone assessment; patient booked into allergy day clinic (Face to Face, tests to be ordered) then either:

AstraZeneca

  • Tests negative to excipients of AZ - vaccine given at GSTT OR allergy confirmed to AZ, allergy service to consider options for vaccination at GSTT/Advise GP that patient requires onward referral for vaccination at a local hospital setting in Kent and Medway (where there is access to resuscitation facilities).

Pfizer

  • Tests negative to Pfizer - vaccine given at GSTT OR allergy confirmed to Pfizer, allergy service to consider vaccinating patient with AZ (non-PEG) – add patient to cohort vaccination by allergy service at GSTT/ Advise GP that patient requires onward referral for vaccination at a local hospital setting in Kent and Medway (where there is access to resuscitation facilities)

If this pathway is followed as advised by the allergy specialist, there will be a very small number of patients who will have to be referred to e-RS as Referral and who will then be triaged over the phone for vaccination either at the local vaccination sites or at the GSTT allergy service.

Further information: we are working hard to stand up a hospital site in Kent and Medway where patient who require hospital setting vaccination can be referred to. We will update you once this service become live. If you require any other information and/ or clarification on the policy and its content, please contact kmccg.svoc@nhs.net. “

Updated on Thursday, 6 January 2022, 29 views