To whom it may concern

This patient has a history of allergic reactions, including rashes and urticaria, after exposure to

and ingestion of various drugs, chemicals, and other foods in the past. Among them, the patient has a history of severe skin inflammation (rash and redness with intense itching) after using

cosmetics and detergents containing PEG (polyethylene glycol), which is a component of

MRNACOVID-19 vaccine manufactured by Pfizer-BioNtech or Moderna. In addition, the patient

has a history of allergic reactions (itching in the throat and urticaria after ingestion) to foods

containing tween (polysorbate) -20, 60, 65, and 80, which are widely used as emulsifiers in

various foods in Japan. For these reasons, it is considered highly likely that strong allergic

reactions such as anaphylaxis, angioedema, and severe urticaria will be observed in this patient,

and therefore COVID-19 vaccination manufactured by Pfizer-BioNtech, Moderna, and Janssen,

which are currently the mainstream COVID-19 vaccines,should be avoided for this patient.

• Health Status

# Food allergy

# Urticaria

# Allergic rhinitis

# Allergic conjunctivitis