Effects of COVID-19 vaccination on chronic urticaria patients: First results of the UCARE COVAC-CU study

ABSTRACT

Background: Chronic urticaria (CU) is a common chronic inflammatory disease. Vaccination against viral infections including COVID-19 can induce increased CU disease activity. As of now, it is unclear how often CU exacerbations occur after COVID-19 vaccination. Method(s) COVAC-CU is an international, multicenter, observational, cross-sectional study of the global network of urticaria centers of reference and excellence (UCAREs). COVAC-CU evaluates the effects of COVID-19 vaccination in patients with CU including rates and risk factors of CU exacerbation. Here, we analyzed 1857 patients with CU who had received at least one COVID-19 vaccination. Data were collected via a questionnaire and retrieved from patient charts. Result(s) Of 1857 patients with CU (median age 42 years;range 18-91 years), 72.1% were female and 71.2%, 14.4% and 14.4% had chronic spontaneous urticaria, chronic inducible urticaria, or both, respectively. Most patients had received two doses of COVID-19 vaccine (79.1%), compared to one (9.7%), three (11%), or four (0.3%). Vaccine type included BTN162b2 (58.4%;BioNTech/Pfizer), ChAdOx1 nCOV-19 (13.8%;AstraZeneca), BBIBP-CorV (8.2%;Sinopharm), Gam-COVID- Vac (8%;Sputnik), mRNA-1273 (5.3%;Moderna), and Ad26.COV 2.5 (4.7%;Janssen/J&J). Less than 10% of patients used premedication, and less than half of patients (44.4%) reported one or more adverse reactions after vaccination. The most common adverse reactions were local injection site reactions (29.6%), fatigue (19.7%), fever (19%), muscle pain (17.9%), headache (14%), and exacerbation of CU (15%). Severe allergic reactions/anaphylaxis were reported by 0.4% of CU patients. In almost all patients who experienced exacerbation of their CU, this occurred within one week after receiving the vaccine, i.e. after 1 to 12 hours (25.8 %), after 12 hours to 48 hours (31.1%) or after 2-7 days (37.9%). Conclusion(s) Most CU patients tolerate COVID-19 vaccination well;severe allergic reaction (anaphylaxis) rates were similar or lower than the self-reported rates reported in the general population. Exacerbation of urticaria was reported in one in five patients, mostly in a week after receiving the vaccine.