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People with a history of significant allergic reactions should not receive the Covid vaccine, the medicines regulator has said, after two NHS workers experienced symptoms on Wednesday.

Both of the NHS staff carry adrenaline autoinjectors, of which the best-known brand is the EpiPen, suggesting they have suffered reactions in the past. These administer a swift adrenaline boost to counter allergic reactions that occur when some people, for instance, eat nuts.

The patient information leaflet with the Pfizer/BioNTech vaccine says it should not be given to people allergic to any substance in the vaccine, raising questions about the wisdom of NHS trusts selecting those staff members to be vaccinated.

“Signs of an allergic reaction may include itchy skin rash, shortness of breath and swelling of the face or tongue,” says the leaflet.

The identities of the NHS workers and hospitals where they were vaccinated have not been disclosed. NHS England confirmed the two incidents and said all trusts had now been advised not to give the jab to people with a history of allergic reaction.

Prof Stephen Powis, the national medical director for the NHS in England, said: “As is common with new vaccines, the MHRA [Medicines and Healthcare products Regulatory Agency] have advised on a precautionary basis that people with a significant history of allergic reactions do not receive this vaccination, after two people with a history of significant allergic reactions responded adversely yesterday. Both are recovering well.”

The MHRA advice states: “Any person with a history of a significant allergic reaction to a vaccine, medicine or food (such as previous history of anaphylactoid reaction or those who have been advised to carry an adrenaline autoinjector) should not receive the Pfizer/BioNtech vaccine. Resuscitation facilities should be available at all times for all vaccinations. Vaccination should only be carried out in facilities where resuscitation measures are available.”

The NHS workers are said to have developed symptoms of “anaphylactoid reaction” shortly after receiving the vaccine, and both have recovered after treatment.