IMPORTANCE Allergic reactions among some individuals who received the Pfizer-BioNTech
(BNT162b2) COVID-19 vaccine discourage patients with allergic conditions from receiving this
vaccine and physicians from recommending the vaccine.

OBJECTIVE To describe the assessment and immunization of highly allergic individuals with the
BNT162b2 vaccine.

DESIGN, SETTING, AND PARTICIPANTS In a prospective cohort study from December 27, 2020, to
February 22, 2021, 8102 patients with allergies who applied to the COVID 19 vaccine referral center
at the Sheba Medical Center underwent risk assessment using an algorithm that included a detailed
questionnaire. High-risk patients (n = 429) were considered “highly allergic” and were immunized
under medical supervision.