Contraindications and Precautions

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At a glance

  • Providers should screen patients for contraindications and precautions to COVID-19 vaccination before administering a vaccine dose.
  • CDC considers the conditions listed in Table 3 to be COVID-19 vaccination contraindications and precautions.
  • There are additional considerations for people with a history of allergies or allergic reactions.

General principles

Healthcare providers who administer vaccines should screen patients for contraindications and precautions before each vaccine dose is administered. CDC considers the conditions listed in Table 3 to be COVID-19 vaccination contraindications and precautions.

Table 3. Contraindications and precautions to COVID-19 vaccination

Medical condition or history Guidance Recommended action
History of a severe allergic reaction* (e.g., anaphylaxis†) after a previous dose or to a component of the COVID-19 vaccine‡ Contraindication Do not vaccinate with the same COVID-19 vaccine type.§
May administer the alternate COVID-19 vaccine type.§
See Considerations for people with a history of allergies and allergic reactions for additional information.
History of a diagnosed non-severe allergy* to a component of the COVID-19 vaccine‡ Precaution May administer the alternate COVID-19 vaccine type.§
For additional information, see Considerations for people with a history of allergies and allergic reactions.
History of a non-severe, immediate (onset less than 4 hours) allergic reaction* after administration of a previous dose of one COVID-19 vaccine type§ Precaution
Moderate or severe acute illness, with or without fever Precaution Defer vaccination until the illness has improved.
History of MIS-C or MIS-A Precaution See COVID-19 vaccination and MIS-C and MIS-A.
History of myocarditis or pericarditis within 3 weeks after a dose of any COVID-19 vaccine Precaution A subsequent dose of any COVID-19 vaccine should generally be avoided.
See COVID-19 vaccination and myocarditis and pericarditis.
Abbreviations: MIS-C = multisystem inflammatory syndrome in children; MIS-A = multisystem inflammatory syndrome in adults
*For definitions of allergic reactions in Table 3 consult Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination.
†Anaphylactic reactions have been rarely reported following receipt of COVID-19 vaccines (estimated incidence: 5 per million doses of mRNA COVID-19 vaccines administered). For more information on the assessment and potential management of anaphylaxis, see Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination.
‡See package inserts for a full list of vaccine ingredients. mRNA COVID-19 vaccines contain polyethylene glycol (PEG).
§The mRNA COVID-19 vaccines (Moderna and Pfizer-BioNTech) are one type of COVID-19 vaccine and the protein subunit vaccine (Novavax) is another type of COVID-19 vaccine.

Considerations for people with a history of allergies or allergic reactions

People with a contraindication to one COVID-19 vaccine type (Table 3) may receive the alternative COVID-19 vaccine type in the usual vaccination setting. Consultation with an allergist-immunologist is encouraged to provide expert evaluation of the original allergic reaction, and depending on the outcome of the evaluation, reassess if administration of additional doses of the same vaccine type may be possible.

People with an allergy-related precaution to one COVID-19 vaccine type (Table 3) may receive the alternative COVID-19 vaccine type in the usual vaccination setting. Vaccination with the same COVID-19 vaccine type may be considered on an individual basis; the same vaccine type should be administered in an appropriate setting and under the supervision of a healthcare provider experienced in the management of severe allergic reactions. Additionally, if the same vaccine type is administered, an observation period of 30 minutes post-vaccination to monitor for allergic reactions and referral to an allergist-immunologist should be considered.

Healthcare professionals and health departments may request a consultation from CDC's Clinical Immunization Safety Assessment (CISA) Project for a complex COVID-19 vaccine safety question not readily addressed by CDC guidance.

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Content Source:
National Center for Immunization and Respiratory Diseases; Coronavirus and Other Respiratory Viruses Division