Updated guidance regarding the risk of allergic reactions to COVID-19 vaccines and recommended evaluation and management: A GRADE assessment and international consensus approach.

"Conflicts of Interest Matthew Greenhawt: has received past research support to his institution from DBV Technologies, and the Agency for Healthcare Research and Quality; receives current research support from Novartis and Silota; is a consultant for Aquestive; is a member of physician/medical advisory boards for DBV Technologies, Nutricia, Novartis, Aquestive, Allergy Therapeutics, AstraZeneca, ALK-Abello, and Prota; is an unpaid member of the scientific advisory council for the National Peanut Board and medical advisory board of the International Food Protein Induced Enterocolitis Syndrome Association; is a member of the Brighton Collaboration Criteria Vaccine Anaphylaxis 2.0 working group; is the senior associate editor for the Annals of Allergy, Asthma, and Immunology, and is member of the Joint Taskforce on Allergy Practice Parameters. He has received honorarium for lectures from ImSci, RMEI Medical Education, MedLearningGroup, and multiple state/local allergy societies. Ronna Campbell: is an author for UpToDate (Waltham, MA, USA) and a consultant for Bryn Pharma (Raleigh, NC, USA) Sharon Chinthrajah: receives grant support from the Consortium for Food Allergy Research (CoFAR), National Institute of Allergy and Infectious Disease (NIAID), Food Allergy Research & Education (FARE), Aimmune, DBV Technologies, Astellas, Novartis, Regeneron, and Astra Zeneca, and is an advisory board member for Alladapt Immunotherapeutics, Novartis, Sanofi, Allergenis, Intrommune Therapeutics, and Genentech. There are no conflicts of interest in this publication John Oppenheimer: is a consultant for Amgen, Aimmune, Aquestive, GSK, Sanofi; member of the Adjudication or Data Safety Monitoring Board for Astra Zeneca, Amgen, Abbvie, Novartis, Glaxo Smith Kline; is the Executive Editor for the Annals of Allergy Asthma and Immunology; and a reviewer for UpToDate. Sayatani Sindher: reports grants from NIH, Regeneron, DBV Technologies, Aimmune, Novartis, CoFAR, and FARE. She is an Advisory member at Genentech and DBV Technologies. There are no conflicts of interest in this publication. Paul Turner: has received grants from Medical Research Council andcNIHR/Imperial Biomedical Research Centre; personal fees and non-financial support from Allergenis, plus grants from UK Medical Research Council, grants and personal fees from UK Food Standards Agency, personal fees and non-financial support from Aimmune Therapeutics, grants from Jon Moulton Charity Trust, personal fees from Aquestive all outside the submitted work."

"Funding: none Matthew Greenhawt: has received past research support to his institution from DBV Technologies, and the Agency for Healthcare Research and Quality; receives current research support from Novartis and Silota; is a consultant for Aquestive; is a member of physician/medical advisory boards for DBV Technologies, Nutricia, Novartis, Aquestive, Allergy Therapeutics, AstraZeneca, ALK-Abello, and Prota; is an unpaid member of the scientific advisory council for the National Peanut Board and medical advisory board of the International Food Protein Induced Enterocolitis Syndrome Association; is a member of the Brighton Collaboration Criteria Vaccine Anaphylaxis 2.0 working group; is the senior associate editor for the Annals of Allergy, Asthma, and Immunology, and is member of the Joint Taskforce on Allergy Practice Parameters. He has received honorarium for lectures from ImSci, RMEI Medical Education, MedLearningGroup, and multiple state/local allergy societies. Timothy Dribin: has received support from the National Institutes of Health, under Award Number 25 2KL2TR001426-05A1 and the National Center for Advancing Translational Sciences of the National Institutes 26 of Health, under Award Number 2UL1TR001425 - 05A1. The content is solely the responsibility of the 27 authors and does not necessarily represent the official views of the NIH Marcus Shaker: serves on the editorial board of The Journal of Allergy and Clinical Immunology In Practice, is an associate editor of Annals of Allergy, Asthma, and Immunology, is a member of the Joint Task Force on Practice Parameters, and has participated in research that has received funding from DBV. Gissele Mosnaim: received past research grant support from Teva, Astra-Zeneca, Alk-Abello, and Genentech and current research grant support from Sanofi-Regeneron, Novartis, and GlaxoSmithKline. Paul Turner: has received grants from Medical Research Council andcNIHR/Imperial Biomedical Research Centre; personal fees and non-financial support from Allergenis, plus grants from UK Medical Research Council, grants and personal fees from UK Food Standards Agency, personal fees and non-financial support from Aimmune Therapeutics, grants from Jon Moulton Charity Trust, personal fees from Aquestive all outside the submitted work."