Most highly allergic individuals can be safely immunized against COVID-19, according to a study published in JAMA Network Open. Investigators observed immunization of highly allergic individuals with the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine in a prospective cohort study of 8,102 patients from December 27, 2020 to February 22, 2021. They found that 97.9% of the patients from the highly allergic group had no immediate allergic event after the first dose of the vaccine, while 1.4% and 0.7% developed minor allergic responses and had anaphylactic reactions, respectively. During the study period, 50.8% of the highly allergic patients received the second vaccine dose, 98.2% and 1.8% of whom had no allergic reactions and minor allergic reactions, respectively. Other immediate and late reactions were comparable to those seen in the general population, apart from delayed itch and skin eruption, which occurred more often in those with allergies.