February 28, 2022
3 min read
Source / Information
Jaggers J, et al. Abstract L04. Presented at: AAAAI annual meeting; 25.-28. February 2022; Phoenix (hybrid meeting).
Information: The authors do not report any relevant financial information.
PHOENIX – Anaphylaxis accounted for 15% of adverse reports from clinicians following mRNA vaccinations for COVID-19, according to a late-breaking abstract at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
Anaphylaxis became more common after vaccination with Pfizer-BioNTech and among white women. Although most of these patients received emergency treatment, few required hospitalization, and none were treated in the intensive care unit, the results showed.
Evidence-based information on side effects may combat hesitation with vaccines in the wake of hypersensitivity reactions reported after COVID-19 vaccinations became available, the researchers said in the study, noting that the CDC reports that approximately five people per day. 1 million vaccinated against COVID-19 have experienced anaphylaxis.
Researchers abstracted anaphylaxis events reported to Massachusetts General Hospital (MGH) and Harvard Medical School Registry of COVID-19 Vaccine Allergy Cases between 13 February 2021 and 22 October 2021.
The Allergy-led, US-based registry collects and shares reports of reactions after COVID-19 vaccination, including rash, swelling and anaphylaxis. Reactions can be reported by patients or by healthcare providers. Healthcare professionals typically complete the individual case forms used in reporting in 10 to 20 minutes.
Data items include health professional information, patient demographics, vaccine site and dose, reaction characteristics, treatment, medication and exposure history, post-reaction consultation with allergy sufferers, skin testing of vaccine allergy, previous personal COVID-19 history and previous food or drug allergies including anaphylaxis.
“The allergy community at MGH identified a need to characterize hypersensitivity reactions because these data were initially unavailable,” Jordon Jaggers, MD, GP in internal medicine at MGH, Healio said.
“This registry was created and is underway, and now we are actively analyzing the data in an effort to be transparent about allergic side effects and as a method of relieving hesitation with vaccines,” she continued.
To date, the registry has collected 2,186 cases reported by patients and 481 reported by healthcare providers.
This analysis included 455 unique patients from 44 US states, including 68 patients (mean age 42 years; standard deviation 18; 88% women; 82% white) who experienced potentially anaphylactic reactions following COVID-19 vaccination.
Doses included Pfizer-BioNTech (71%), Moderna (25%) and Johnson & Johnson / Janssen (1%) vaccines, with 3% unknown. Fifty-five (81%) of these reactions occurred after the initial dose.
Patients’ medical histories included atopic disease (56%), asthma (41%), previous anaphylaxis (41%), allergic rhinitis (32%), and chronic urticaria (7%). Previous reactions were triggered by medication (18%), food (16%), poison (6%) and idiopathic causes (3%).
In addition, 60% experienced symptoms 15 minutes after vaccination, and 81% experienced them within 30 minutes. Anaphylactic reactions to the vaccines involved airways (68%), skin / mucosa (63%), cardiovascular system (28%) and gastrointestinal system (7%).
Respiratory symptoms included shortness of breath (41%), feeling of tightness of the throat (34%), wheezing (13%), dry cough (12%) and swelling of the upper respiratory tract (10%). No patients experienced low oxygen saturation.
Dermatological symptoms included swollen lips, tongue or larynx (24%); other swelling or angioedema (28%); generalized hives (24%); itching (19%) and other unspecified rash (12%).
Common cardiovascular symptoms included high heart rate (18%) and high blood pressure (10%), whereas few patients experienced chest tightness, low blood pressure, or syncope. None of the patients experienced bradycardia or other arrhythmias.
Gastrointestinal symptoms, which were rare, included primarily nausea and abdominal pain.
In addition, 62% of these reactions required treatment in ED, but only 4% required hospitalization, while 11% were treated at home. The rest were treated in emergency clinics, retail pharmacies and vaccine or allergy clinics. Treatments included H1 blockers (76%), oral steroids (22%), IV steroids (29%) and intramuscular adrenaline (38%) or epinephrine drip (3%), with 12% not requiring treatment.
“The most reassuring thing is that very few patients required hospitalization,” Jaggers said. “No one was treated in the intensive care unit and no deaths were reported.”
According to the researchers, 56 of these patients followed up with an allergic assessment and 88% of them were diagnosed with confirmed or possible anaphylaxis. The remaining seven (12%) were found to be inconsistent with anaphylaxis, with five of these reports being attributed to patient anxiety.
The researchers then noted the key role that allergy sufferers may play in distinguishing between suspected and true anaphylaxis, and they said they also plan to continue their work.
“We plan to send follow-up studies to patients and healthcare professionals to see if they continued to tolerate their second dose or booster dose of the vaccine and gather additional information,” Jaggers said.
The registry is still open to both clinicians and patients, and data can be entered online.