For patients with an allergic reaction to their first dose of mRNA COVID-19 vaccination, the risk for repeated immediate allergic and severe immediate allergic reactions associated with a second dose is low, according to a study published in JAMA Internal Medicine. Derek K. Chu, MD, PhD, and colleagues examined these risks among 1,366 individuals with an immediate allergic reaction to the first dose included in 22 studies. Six patients developed severe immediate allergic reactions after their second vaccination (absolute risk, 0.16%), while 1,360 (99.84%) tolerated the dose. Overall, 232 patients (13.65%) experienced mild immediate non-severe symptoms with their second dose. Among 78 people with severe immediate allergic reactions to their first mRNA COVID-19 vaccination, four (4.94%) and 15 (9.54%) had a second severe immediate reaction and non-severe symptoms, respectively. No deaths were reported.