Acute asthma exacerbation due to the SARS-CoV-2 vaccine (Pfizer-BioNTech BNT162b2 messenger RNA COVID-19 vaccine [ComirnatyⓇ])

Ando, Masayuki; Satonaga, Yoshio; Takaki, Ryuichiro; Yabe, Michitoshi; Kan, Takamasa; Omote, Erika; Yamasaki, Toru; Komiya, Kosaku; Hiramatsu, Kazufumi

doi:10.1016/j.ijid.2022.09.019

Cited by 7 publications

(8 citation statements)

References 10 publications

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“…In two of these reports, similarly to ours, bronchial asthma worsened the day after vaccination, which suggests a delayed allergic reaction (lymphocytic involvement) [ 4 , 7 ]. Ando et al also suggested sensitization to the vaccine based on an increase in peripheral blood eosinophils after vaccine administration [ 4 ]. However, our patient had no change in eosinophil levels after either of the vaccine administrations.…”

Section: Discussionsupporting

confidence: 71%

“…Th2-type disorders caused by the BNT162b2 vaccine appear to be rare, although several case reports have been published regarding Th2-type disorders associated with eosinophils, including eosinophilic polyangiitis granulomatosis [ 6 ]. Three previous studies have reported COVID-19 vaccine-induced asthma exacerbations (Table 1 ) [ 3 , 4 , 7 ]. In two of these reports, similarly to ours, bronchial asthma worsened the day after vaccination, which suggests a delayed allergic reaction (lymphocytic involvement) [ 4 , 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Three previous studies have reported COVID-19 vaccine-induced asthma exacerbations (Table 1 ) [ 3 , 4 , 7 ]. In two of these reports, similarly to ours, bronchial asthma worsened the day after vaccination, which suggests a delayed allergic reaction (lymphocytic involvement) [ 4 , 7 ]. Ando et al also suggested sensitization to the vaccine based on an increase in peripheral blood eosinophils after vaccine administration [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

“…Serious allergic reactions include anaphylaxis [ 1 ]; however, the incidence is very low, at 4.8 per million doses [ 2 ], and other allergic reactions are unknown. The BNT162b2 vaccine is safe to administer in patients with bronchial asthma; however, case reports have been published regarding patients sensitized to the BNT162b2 vaccine developing bronchial asthma or experiencing asthma exacerbations [ 3 , 4 ]. The patient in this present study had severe bronchial asthma that was controlled with a biologic agent and developed recurrent asthma exacerbations after the fourth and fifth doses of the BNT16b2 vaccine.…”

Section: Introductionmentioning

confidence: 99%

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Coronavirus Disease 2019 Vaccine-Induced Flare-Up of Severe Bronchial Asthma Previously Controlled With Dupilumab: A Case Report

Sumi¹,

Kodama²,

Nishikiori³

et al. 2023

Cureus

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The widespread after-effects of the coronavirus disease 2019 are still a grave threat worldwide. Among them are adverse reactions to vaccines, including those most observed following Pfizer-BioNTech (BNT162b2) vaccine administration, namely, local reactions at the injection site, fatigue, headache, myalgia, chills, arthralgia, and fever. Patients with asthma particularly present with unique adverse reactions to the BNT162b2 vaccine, notably, an exacerbation in their asthma symptoms as highlighted through the current case report. In this case, a 50-year-old woman had been undergoing treatment for bronchial asthma in the form of inhalation steroids and dupilumab, as well as systemic steroid prednisolone as maintenance therapy. She had mild injection site reactions after her first three COVID-19 vaccinations. She also experienced acute exacerbation requiring hospitalization after the fourth and fifth doses. Her symptoms resolved following steroid therapy. The close association between the timing of vaccinations and the onset of clinical symptoms suggests that the exacerbation episodes were triggered by the vaccine. Therefore, although the BNT162b2 vaccine is safe to administer in patients with bronchial asthma, cases reporting patients sensitized to the BNT162b2 vaccine developing bronchial asthma or experiencing asthma exacerbations should not be neglected. Clinicians should be aware of the possibility of flare-ups induced by repeated COVID-19 vaccinations in such patients.

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Section: Discussionsupporting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Coronavirus Disease 2019 Vaccine-Induced Flare-Up of Severe Bronchial Asthma Previously Controlled With Dupilumab: A Case Report

Sumi¹,

Kodama²,

Nishikiori³

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…One prospective cohort study found that the incidence of allergy increased among those at particularly high risk of allergy after receiving the BNT162b2 vaccine [ 17 ]. In one case report from Japan, a patient developed life-threatening acute asthma exacerbation after BNT162b2 vaccination [ 18 ]. As the risk of allergic reactions is higher in individuals with a history of allergies than in individuals without a history of allergies and as patients with asthma may be at increased risk as well, the advantages and disadvantages of vaccinating high-risk individuals should be fully explained to the patients to support their decision-making process.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 mRNA vaccination status and concerns among pregnant women in Japan: a multicenter questionnaire survey

Takahashi

Samura

Hasegawa

et al. 2023

BMC Pregnancy Childbirth

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Background mRNA vaccination is an effective, safe, and widespread strategy for protecting pregnant women against infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, information on factors such as perinatal outcomes, safety, and coverage of mRNA vaccinations among pregnant women is limited in Japan. Therefore, this study aimed to investigate the perinatal outcomes, coverage, adverse effects, and short-term safety of mRNA vaccination as well as vaccine hesitancy among pregnant women. Methods We conducted a multicenter online survey of postpartum women who delivered their offspring at 15 institutions around Tokyo from October 2021 to March 2022. Postpartum women were divided into vaccinated and unvaccinated groups. Perinatal outcomes, COVID-19 prevalence, and disease severity were compared between the two groups. Adverse reactions in the vaccinated group and the reasons for being unvaccinated were also investigated retrospectively. Results A total of 1,051 eligible postpartum women were included. Of these, 834 (79.4%) had received an mRNA vaccine, while 217 (20.6%) had not, mainly due to concerns about the effect of vaccination on the fetus. Vaccination did not increase the incidence of adverse perinatal outcomes, including fetal morphological abnormalities. The vaccinated group demonstrated low COVID-19 morbidity and severity. In the vaccinated group, the preterm birth rate, cesarean section rate, and COVID-19 incidence were 7.2%, 33.2%, and 3.3%, respectively, compared with the 13.7%, 42.2%, and 7.8% in the unvaccinated group, respectively. Almost no serious adverse reactions were associated with vaccination. Conclusions mRNA vaccines did not demonstrate any adverse effects pertaining to short-term perinatal outcomes and might have prevented SARS-CoV-2 infection or reduced COVID-19 severity. Concerns regarding the safety of the vaccine in relation to the fetus and the mother were the main reasons that prevented pregnant women from being vaccinated. To resolve concerns, it is necessary to conduct further research to confirm not only the short-term safety but also the long-term safety of mRNA vaccines.

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The association between COVID-19 vaccine/infection and new-onset asthma in children - based on the global TriNetX database

Yang,

Shih,

Lung

2024

Infection

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Introduction The COVID-19 pandemic has underscored the importance of its potential long-term health effects, including its link to new-onset asthma in children. Asthma significantly impacts children’s health, causing adverse outcomes and increased absenteeism. Emerging evidence suggests a potential association between COVID-19 infection and higher rates of new-onset asthma in adults, raising concerns about its impact on children’s respiratory health. Methods A retrospective cohort study design was employed, using electronic medical records from the TriNetX database, covering January 1, 2021, to December 31, 2022. Two cohorts of children aged 5 to 18 who underwent SARS-CoV-2 RT-PCR testing were analyzed: unvaccinated children with and without COVID-19 infection, and vaccinated children with and without infection. Propensity score matching was used to mitigate selection bias, and hazard ratio (HR) and 95% CI were calculated to assess the risk of new-onset asthma. Results Our study found a significantly higher incidence of new-onset asthma in COVID-19 infected children compared to uninfected children, regardless of vaccination status. In Cohort 1, 4.7% of COVID-19 infected children without vaccination developed new-onset asthma, versus 2.0% in their non-COVID-19 counterparts within a year (HR = 2.26; 95% CI = 2.158–2.367). For Cohort 2, COVID-19 infected children with vaccination showed an 8.3% incidence of new-onset asthma, higher than the 3.1% in those not infected (HR = 2.745; 95% CI = 2.521–2.99). Subgroup analyses further identified higher risks in males, children aged 5–12 years, and Black or African American children. Sensitivity analyses confirmed the reliability of these findings. Conclusion The study highlights a strong link between COVID-19 infection and an increased risk of new-onset asthma in children, which is even more marked in those vaccinated. This emphasizes the critical need for ongoing monitoring and customized healthcare strategies to mitigate the long-term respiratory impacts of COVID-19 in children, advocating for thorough strategies to manage and prevent asthma amidst the pandemic.

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Acute asthma exacerbation due to the SARS-CoV-2 vaccine (Pfizer-BioNTech BNT162b2 messenger RNA COVID-19 vaccine [ComirnatyⓇ])

Cited by 7 publications

References 10 publications

Coronavirus Disease 2019 Vaccine-Induced Flare-Up of Severe Bronchial Asthma Previously Controlled With Dupilumab: A Case Report

Coronavirus Disease 2019 Vaccine-Induced Flare-Up of Severe Bronchial Asthma Previously Controlled With Dupilumab: A Case Report

COVID-19 mRNA vaccination status and concerns among pregnant women in Japan: a multicenter questionnaire survey

The association between COVID-19 vaccine/infection and new-onset asthma in children - based on the global TriNetX database

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