Allergic Reactions After COVID-19 Vaccination—Putting Risk Into Perspective

Phillips, Elizabeth

doi:10.1001/jamanetworkopen.2021.22326

Cited by 5 publications

(7 citation statements)

References 6 publications

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“…Those considered highly to have allergy were monitored for 2 hours after vaccination in a specialized setting and those at low risk for 30 minutes in a routine setting. 20,21 They did not vaccinate patients with a history of allergy to two or more injectable drugs or PEG. Of the 429 patients deemed highly to have allergy and observed for 2 hours, 9 patients, all women (2.1%), had immediate reactions, of which most were mild, and 3 (0.7% overall) experienced anaphylaxis, which resolved with epinephrine and without hospitalization.…”

Section: Epidemiology Of Allergic Events and Vaccine Rollout Of Sever...mentioning

confidence: 99%

“…This is evidence against an IgEmediated mechanism. 21 Systemic Reactions-Non-immune mediated Vasovagal reactions are relatively common following vaccine administration and unless fastidiously documented can be confusing retrospectively. It is thus essential for a clinician to be able to recognize these reactions and to distinguish them from anaphylaxis.…”

Section: Immediate Reactions Systemic Reactions-immune Mediatedmentioning

confidence: 99%

See 1 more Smart Citation

What have we learned about the allergenicity and adverse reactions associated with the severe acute respiratory syndrome coronavirus 2 vaccines: One year later

Copaescu

Duque

Phillips

2022

Annals of Allergy, Asthma & Immunology

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Section: Epidemiology Of Allergic Events and Vaccine Rollout Of Sever...mentioning

confidence: 99%

Section: Immediate Reactions Systemic Reactions-immune Mediatedmentioning

confidence: 99%

What have we learned about the allergenicity and adverse reactions associated with the severe acute respiratory syndrome coronavirus 2 vaccines: One year later

Copaescu

Duque

Phillips

2022

Annals of Allergy, Asthma & Immunology

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“…Serious adverse events related to vaccinations are extremely rare. They may include anaphylaxis [9], myocarditis and pericarditis [10] (after mRNA vaccines) or provoke thrombosis with thrombocytopenia syndrome [11] (after adenovirus vector-based vaccines), and possibly Guillain-Barré syndrome [12].…”

Section: Introductionmentioning

confidence: 99%

Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

et al. 2022

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Background Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are used to reduce the risk of developing Coronavirus Disease 2019 (COVID-19). Despite the significant benefits in terms of reduced risk of hospitalization and death, different adverse events may present after vaccination: among them, headache is one of the most common, but nowadays there is no summary presentation of its incidence and no description of its main features. Methods We searched PubMed and EMBASE covering the period between January 1st 2020 and August 6th, 2021, looking for record in English and with an abstract and using three main search terms (with specific variations): COVID-19/SARS-CoV-2; Vaccination; headache/adverse events. We selected manuscript including information on subjects developing headache after injection, and such information had to be derived from a structured form (i.e. no free reporting). Pooled estimates and 95% confidence intervals were calculated. Analyses were carried out by vaccine vs. placebo, by first vs. second dose, and by mRNA-based vs. “traditional” vaccines; finally, we addressed the impact of age and gender on post-vaccine headache onset. Results Out of 9338 records, 84 papers were included in the review, accounting for 1.57 million participants, 94% of whom received BNT162b2 or ChAdOx1. Headache was generally the third most common AE: it was detected in 22% (95% CI 18–27%) of subjects after the first dose of vaccine and in 29% (95% CI 23–35%) after the second, with an extreme heterogeneity. Those receiving placebo reported headache in 10–12% of cases. No differences were detected across different vaccines or by mRNA-based vs. “traditional” ones. None of the studies reported information on headache features. A lower prevalence of headache after the first injection of BNT162b2 among older participants was shown. Conclusions Our results show that vaccines are associated to a two-fold risk of developing headache within 7 days from injection, and the lack of difference between vaccine types enable to hypothesize that headache is secondary to systemic immunological reaction than to a vaccine-type specific reaction. Some descriptions report onset within the first 24 h and that in around one-third of the cases, headache has migraine-like features with pulsating quality, phono and photophobia; in 40–60% of the cases aggravation with activity is observed. The majority of patients used some medication to treat headache, the one perceived as the most effective being acetylsalicylic acid.

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“…The finding that patients with symptoms concerning for anaphylaxis may tolerate the second dose of the vaccine led to a discussion of the mechanism of apparent anaphylaxis to the vaccine [ 24 ]. Our classic understanding of IgE-mediated reactions would not allow for tolerance within a short period [ 25 ], but non-IgE-mediated pathways can result in variable activation of mast cells and basophils to cause symptoms clinically consistent with anaphylaxis reactions [ 26 , 27 ]. Another diagnostic cause to be considered in the differential diagnosis of our patients’ symptoms is the possibility of anxiety related to the administration of the vaccine, deemed immunization stress–related response [ 28 ].…”

Section: Epidemiology Of Allergic Reactionsmentioning

confidence: 99%

mRNA COVID-19 Vaccine Anaphylaxis: Epidemiology, Risk Factors, and Evaluation

Jaggers

Wolfson

2023

Curr Allergy Asthma Rep

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Purpose of Review The COVID-19 vaccines have proved essential in our defense against the COVID-19 pandemic. However, concerns regarding allergic reactions to the vaccines persist to this day. Herein, we review the data regarding the frequency of allergic reactions to the COVID-19 vaccines, the epidemiology, and the management of patients reporting vaccine allergic reactions. Recent Findings Although initial reports emphasized a high risk of anaphylaxis to the COVID-19 vaccines, more recent data demonstrate similar rates of anaphylaxis to the COVID-19 vaccines as to other vaccines. Alternative explanations for increased rates of apparent allergic reactions are discussed, including the role for stress-related and nocebo responses. Summary COVID-19 vaccines and mRNA vaccine technology are overwhelmingly safe and well-tolerated by most patients. Careful history and case review will enable the discerning physician to safely vaccinate most patients. Rare patients with objective signs and symptoms of anaphylaxis may be candidates for alternatives to vaccination including monoclonal antibodies.

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Allergic Reactions After COVID-19 Vaccination—Putting Risk Into Perspective

Cited by 5 publications

References 6 publications

What have we learned about the allergenicity and adverse reactions associated with the severe acute respiratory syndrome coronavirus 2 vaccines: One year later

What have we learned about the allergenicity and adverse reactions associated with the severe acute respiratory syndrome coronavirus 2 vaccines: One year later

Headache onset after vaccination against SARS-CoV-2: a systematic literature review and meta-analysis

mRNA COVID-19 Vaccine Anaphylaxis: Epidemiology, Risk Factors, and Evaluation

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