Less than a year after the first detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), vaccines have been approved for routine use in numerous countries and have already been used in mass vaccination programs . Vaccines include the mRNA BNT162b2 and mRNA 1273 . Allergic reactions and anaphylaxis account for a substantial proportion of the adverse reactions to these vaccines observed to date, but overall they are rare . The incidence of anaphylaxis in the context of SARS-CoV‑2 vaccination with the mRNA vaccines appears to be approximately 10-fold higher than with previous vaccines, at approximately 1 per 100,000 vaccine injections . One focus of the present article is a systematic review of the components of mRNA vaccines against``coronavirus disease 2019``(COVID-19). Differences from established vaccines are addressed and the allergic potential of liposomes, polyethylene glycol, tromethamine/trometamol, and mRNA are discussed . Another focus is on the clinical presentation and course of allergic reactions to the COVID-19 vaccines . This is followed by a discussion of the therapeutic approach to anaphylactic reactions, as well as the drugs and medical supplies required to treat them . It is important to note that any vaccinee may be affected by anaphylaxis, regardless of whether or not allergic diseases are already known . Therefore, every vaccination site and every vaccinator must be prepared to recognize and treat severe allergic reactions.