Xolair and Covid-19 vaccine, what should I know?
If you are being treated with Xolair, you can be vaccinated with the COVID-19 vaccination at any time, but the ACAAI (American College of Allergy, Asthma, and Immunology) recommends that the COVID-19 vaccine and Xolair not be given on the same day since, if a reaction or a side effect occurs, it may be challenging to work out which injection was to blame. The ACAAI suggests separating the COVID-19 vaccination and Xolair by at least 24 hours. There is no reason to stop Xolair until you complete the course of the COVID-19 vaccinations.
Some countries (such as Germany) recommend allowing a spacing of at least a week between the COVID-19 vaccination and a Xolair injection; however, this is not the position of the ACAAI.
Because Xolair works on the allergic arm of the immune system, it does not appear to compromise the immune system like traditional immunosuppressants, such as prednisone and cyclosporine. Xolair is not associated with an increased risk of infection nor increases the risk for COVID-19. If you are taking Xolair for asthma, nasal polyps, or urticaria you are not at increased risk for allergic reactions after the COVID-19 vaccination. There is no data to suggest that biologics have any effect (good or bad) on a person’s response to a COVID-19 vaccine including a booster injection. Only patients on daily oral corticosteroids of 20mg or more are considered immunocompromised by the CDC.
- Pfaar, O., Klimek, L., Hamelmann, E., Kleine-Tebbe, J., Taube, C., Wagenmann, M., Werfel, T., Brehler, R., Novak, N., Mülleneisen, N., Becker, S., & Worm, M. (2021). COVID-19 vaccination of patients with allergies and type-2 inflammation with concurrent antibody therapy (biologicals) - A Position Paper of the German Society of Allergology and Clinical Immunology (DGAKI) and the German Society for Applied Allergology (AeDA). Allergologie select, 5, 140–147. https://doi.org/10.5414/ALX02241E
- Frequently Asked Patient Questions About the COVID-19 Vaccine. American College of Allergy, Asthma, and Immunology. https://acaai.org/news/allergy/
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- Xolair Information for Consumers
- Xolair prescribing info & package insert (for Health Professionals)
- Side Effects of Xolair (detailed)