Photo of Allergic black man blowing on wipe in a park on spring season a sunny day

Is it Allergies or COVID-19?

Allergies are never pleasant or convenient. During a global pandemic, they can be confusing or even alarming. The COVID-19 pandemic has forced many people to watch their health and symptoms more closely. For allergy sufferers, this is a daily concern during the height of allergy season. If you wake up with a cough or itchy eyes, you may ask yourself, “Is it COVID-19 or allergies?” This is a reasonable concern. It is important to understand the difference between COVID-19 vs. allergies.

What are the symptoms of COVID-19? 

Symptoms of COVID-19 vary from person to person but may include:

  • fever or chills
  • cough
  • shortness of breath or difficulty breathing.
  • fatigue
  • muscle or body aches
  • headache
  • new loss of taste or smell
  • sore throat
  • congestion or runny nose
  • nausea or vomiting
  • diarrhea

These symptoms typically develop between 2 and 14 days from exposure to the virus.

What are the symptoms of allergies?

Like COVID-19, seasonal allergies vary from person to person, but common seasonal allergy symptoms include:

  • runny nose, usually with clear or pale-colored mucus
  • sneezing
  • coughing
  • red, watery eyes
  • itching around the nose, mouth, or eyes

Left untreated, people with seasonal allergies may develop:

  • nasal congestion
  • headache
  • sore throat
  • postnasal drip
  • decreased sense of smell
  • sinus infections (also called sinusitis)
  • ear infections
  • puffiness or dark circles under the eyes
  • shortness of breath
  • fatigue

These symptoms may appear at different times of the year depending on what triggers your allergies. Tree pollen is a frequent source of early spring allergies, while grass pollen is more problematic during the early summer. Ragweed pollen emerges in late summer and fall. Mold allergies can be an issue in fall and winter.

What is the difference between COVID-19 and allergies?

Although there is some overlap between allergy vs COVID-19 symptoms, these are two vastly different health issues.

COVID-19 is a contagious virus that is easily transmitted person-to-person. Allergies are caused by your immune system reacting to an exposure to an allergen, such as pollen. Allergies are not contagious.

How to know: Is it allergy or COVID-19? 

COVID-19 and allergies have overlapping symptoms. Before you get too bogged down wondering if your symptoms are COVID-19 or allergies, there are some questions you can ask yourself, including:

Have I recently been in contact with someone with known COVID-19?

If the answer is yes, and you have symptoms of COVID-19, then consider getting tested.

Do I have a fever, cough, or shortness of breath?

Fever, cough and shortness of breath are three of the most common COVID-19 symptoms. If you have these symptoms, consider getting testing and/or seeking care from a doctor. This is especially important if you had contact with someone who has  a positive COVID-19 test.

A fever is not a sign of seasonal allergies. If you have a fever of 100.4 or higher, even with other allergy symptoms, consider getting tested for COVID-19 and/or seeking care from a doctor.

There may not be a distinguishable difference between an allergy cough vs. COVID-19 cough. Both can trigger a dry cough. But COVID-19 does not normally cause a “wet” cough (where you cough up phlegm), while allergies sometimes can.

Do I normally have seasonal allergies this time of year? Are these symptoms consistent with my normal allergy symptoms? 

If you answered yes to both questions, then that should reduce the concern that you have COVID-19, especially if you don’t have a fever.

If you don’t normally get seasonal allergies or your symptoms are different, that may be cause for concern. You may want to get tested for COVID-19 and/or consult your doctor.

There is no precise way to determine if you have seasonal allergies or COVID-19. Consider the big picture. Review your symptoms, recent contacts and your personal health history. If at all in doubt, contact your doctor to discuss your concerns.

What are some special considerations for allergy patients in the COVID-19 era?

The overlapping symptoms of COVID-19 and allergies can create extra worry during allergy season. There is no evidence to suggest that people with allergies are at greater risk for COVID-19. That doesn’t mean that you should abandon methods to prevent infection. You should continue to wear a mask, practice social distancing, avoid large crowds and practice good hand hygiene. You may even find improved allergy symptoms as masks may help protect you from exposure to pollens.

Here are some questions you may have if you live with allergies:

Should I take preventive medicine for allergies during COVID-19?

Prevention is key in allergy treatment. If you normally have seasonal allergies, start your medicine early. Allergists say you should start taking your allergy medicine about 2 weeks before you usually develop symptoms. This will help reduce your allergy symptoms when they arrive.

If you have been taking your allergy medicine for a few weeks and one day wake up with a cough, shortness of breath and body aches, it may be an indication you have COVID-19. Take steps to get tested.

Should people with a history of allergies get the COVID-19 vaccine?

People with allergies should get the COVID-19 vaccine. There is no evidence to suggest people with a history of seasonal allergies are at higher risk for vaccine reactions. The vaccine will help prevent you from either getting COVID-19 or from getting very sick if you do get it.

The only people who should not receive the vaccine are those with a history of severe reactions to one or more of its ingredients. Two of the vaccines — Pfizer/BioNTech and Moderna — contain polyethylene glycol (PEG) or polysorbate, which can cause allergic reactions in some people. If you have a history of severe allergic reactions to vaccines or other injectable medications, talk to your doctor before scheduling the vaccine.

Medical experts do not recommend that people with a history of severe reactions to vaccines not get the COVID-19 vaccine. Rather, they recommend health professionals monitor patients for 30 minutes to see if symptoms arise. Facilities administering the COVID-19 vaccine should be equipped to treat severe allergic reactions. Bring your own epinephrine auto-injector for extra protection.

Should I get a second COVID-19 vaccine if I have a severe reaction to the first shot?

If you have a severe allergic reaction after receiving a first dose of the COVID-19 vaccine, then you should not get the second dose. Talk with your doctor about your options for COVID-19 protection.

Should I take my allergy medication the same day as I get my COVID-19 vaccine?

You may take allergy medications the same day you receive the COVID-19 vaccine. If you are on high-dose oral or injectable corticosteroids, talk with your doctor before getting the vaccine.

If you do not routinely take allergy medicine, do not premedicate with allergy medicine before a COVID-19 vaccination.

Should I take my allergy immunotherapy shots or other biologic medications the same day as my COVID-19 vaccine? 

Current guidance states that you should not take allergy immunotherapy shots or biologics the same day as your COVID-19 vaccination. If you get allergy shots, it’s recommended you wait 48 hours between your shot and the vaccine.

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