Evidence for COVID-19 vaccination in adolescents

Background. Vaccination against COVID-19 is one of the effective measures in adults to reduce the risk of severe disease. However, the emerging risk of post-vaccination myocarditis in adolescents should be considered when assessing the benefit/risk balance of routine vaccination of these patients. Aim. To summarize the efficacy and safety evidence for COVID vacci-nation in adolescents. Methods. This is a narrative review of the published literature. Results. The risks of myocarditis and hospitalization for COVID-19 infec-tion are 122/100,000 and 64/100,000 adolescents, respectively. Their vac-cination reduces the risk of symptomatic COVID-19 infection by almost 100% and the risk of hospitalization by a factor of 10. French, American, and Israeli pharmacovigilance data estimate a risk of post-vaccination myocarditis varying between 1 and 14 cases per 100,000 vaccinated adolescents and of post-vaccination hospitalization of 10/100,000. Conclusion. Routine vaccination of adolescents appears to reduce the risk of hospitalization despite rare mild to moderate myocarditis. However, the barrier measures are still recommended given the high prevalence of the Delta variant in France.

Vaccination against COVID-19 and allergic risk: considerations for use in general practice

Context. General practitioners (GPs) work alongside to help provide a COVID-19 vaccination for anyone. They face plenty of questions from concerned patients, such as about vaccine-related anaphylaxis. Objective. To provide an up-to-date overview to help GPs answer questions about a COVID-19 vaccination in case of history of allergies. Methods. A narrative literature review was performed until January 21, 2021. Data were collected from French and international authorities guidance and the main international scientific societies of Allergy. The guidelines for the management of anaphylaxis were added a posteriori. Results. Anaphylactic reactions related to the mRNA COVID-19 vaccine are very rare. A history of allergic reactions or anaphylaxis is generally not a contraindication to the vaccination, except in case of a systemic reaction to the 1st dose of the vaccine or a previous reaction to any of its components. These are absolute ones. People with a local reaction to the 1st dose can receive the 2nd dose. Conclusion. The up-to-date collected data are reassuring: the rate of anaphylaxis related to the mRNA COVID-19 vaccine is similar to other vaccines. People with history of allergies, including anaphylaxis (except for the COVID-19 vaccine or its components), can receive the vaccine. The benefit of the vaccination in case of history of allergies outweighs the risk. These data will allow GPs and their patients to make an enlightened and more rational choice in the shared decision-making process.