Covid Hives

Provided by: Philip Rancitelli, MD

The allergists/immunologists at Ohio ENT & Allergy Physicians are encountering many patients who describe itching and hives after booster COVID-19 vaccinations (some after being infected with COVID-19).  In fact, this is a phenomenon we’re hearing about from our colleagues all over the country.  It was a hot topic at the recent American Academy of Allergy, Asthma, and Immunology (AAAAI) meeting in Phoenix, Arizona.

Hives (urticaria) can occur for a variety of reasons, not just allergies.  When hives and/or itching occur on most days for longer than six weeks (we call this “chronic urticaria”), it’s usually not due to an allergy, and very rarely is a cause identified.  However, chronic urticaria is usually nothing to worry about and is very treatable.

It is known that infections can trigger hives.  Interestingly, we see more patients with hives during the cold weather months when respiratory pathogens are more prominent.  The immune response to infections can activate pathways in our immune system that cause hives.  Again, this is usually nothing to worry about and is typically short-lived.  In rare cases, infections can trigger chronic urticaria.  

COVID-19 and COVID-19 vaccines induce very strong immune responses, so it’s not surprising that hives can follow exposure.  We have observed hives starting a few days to a few weeks after vaccination.  With natural infection, hives might occur prior, during, or after symptoms begin.  Keep in mind, hives within minutes of vaccination might indicate an allergic reaction to an ingredient in the vaccine.  Studies have shown, however, that most individuals who experience hives after COVID-19 vaccination can safely receive subsequent doses.

The board-certified pediatric and adult allergists/immunologists at Ohio ENT & Allergy Physicians are more than happy to help determine if hives are due to an allergy, infection, or something else.  Additionally, we can partner with you to construct an individualized treatment plan to alleviate your symptoms!