COVID-19 vaccine-related presumed allergic reactions and second dose administration by using a two-step graded protocol.
Allergy Asthma Proc
; 42(6): 515-521, 2021 Nov 01.
Article
in English
| MEDLINE | ID: covidwho-1607107
ABSTRACT
Background:
Acute allergic reactions to messenger RNA (mRNA) vaccines are rare but may limit public health immunization efforts.Objectives:
To characterize suspected allergic reactions to the first dose of coronavirus disease 2019 (COVID-19) mRNA vaccine and to assess the safety and utility of a two-step graded-dose protocol for the second dose of the Pfizer-BioNTech vaccine in patients with a history of low suspicion of anaphylaxis to their first dose.Methods:
This was a retrospective evaluation of referrals to the allergy and immunology clinic for a presumed allergic reaction to the first dose of the COVID-19 mRNA vaccine (Pfizer-BioNTech or Moderna) between December 17, 2020, and February 28, 2021. Recommendations for the second dose and outcomes were evaluated by trained board-certified allergists.Results:
Seventy-seven patients presented with a Pfizer-BioNTech reaction (56 [72.7%]) or with a Moderna reaction (21 [27.3%]). Most patients (69.7%) had symptom onset within 4 hours. Most commonly reported symptoms were cutaneous (51.9%), cardiovascular (48.1%), and respiratory (33.8%) symptoms. Recommendations included to proceed with the single dose (70.1%), two-step graded dose (19.5%), or deferral (10.4%). Twelve of 15 patients completed the second dose with a graded-dose protocol. Of these patients, five reported at least one or more similar symptoms as experienced with their first dose.Conclusion:
Of the patients with presumed allergic reactions to their first dose of COVID-19 mRNA vaccine, most were able to safely receive the second dose. For those with a low suspicion of anaphylaxis, the two-step graded protocol with the Pfizer-BioNTech vaccine was well tolerated. A graded-dose protocol could be an effective strategy for second-dose vaccination in those who may otherwise defer the second dose.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Vaccines, Synthetic
/
COVID-19 Vaccines
/
COVID-19
/
Hypersensitivity
/
Anaphylaxis
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Topics:
Vaccines
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Allergy Asthma Proc
Journal subject:
Allergy and Immunology
Year:
2021
Document Type:
Article
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