Pfizer-BioNTech COVID-19 Vaccine Tolerance in Allergic versus Non-Allergic Individuals

Abstract

Individuals with a history of allergy are potentially at risk of suffering from adverse effects after COVID-19 vaccination. We sought to assess the tolerance towards the Pfizer-BioNTech vaccine in allergic patients. To address this issue, we used a questionnaire conducted on-line in a group of medical professionals who were vaccinated with the Pfizer-BioNTech vaccine. A total of 1808 respondents, out of whom 1707 received two doses of the vaccine, returned the questionnaire. Local reactions after injection were more frequent in allergic individuals after both doses (swelling p = 0.0003). Systemic adverse events (AE-SYS) occurred more often after the second than the first dose in both groups (allergic persons: 77.29% vs 41.06%); vomiting and arthralgia occurred more often in allergic subjects (p = 0.0009). AE-SYS in allergic individuals lasted longer than in non-allergic ones after the first (p = 0.01) and the second dose (p = 0.0009). Allergic reactions after vaccination were reported more frequently in allergic subjects: after the first dose (p = 0.00001) and after the second dose (p = 0.001). Rhinitis was the most frequent symptom observed more often in allergic patients. No severe allergic reactions occurred during the full cycle of vaccination. Although the Pfizer-BioNTech vaccine is tolerated worse by allergic than non-allergic individuals, the occurring adverse symptoms are mild and do not preclude a successful completion of the vaccination cycle. The presence of symptoms suggestive of allergy does not constitute a condition of increased risk of developing clinically significant adverse events following Pfizer COVID-19 vaccination.

Age- and Sex-Graded Data Evaluation of Vaccination Reactions after Initial Injection of the BNT162b2 mRNA Vaccine in a Local Vaccination Center in Germany

“…The basic requirement would be a high level of vaccine coverage, including those over 80 years (at the end of 2018 there were 2.3 million people in Germany ≥85 years of age) [ 26 ]. The data collected in our study with evidence of an extremely low rate of vaccination side effects, as also reported by other studies [ 27 ], especially in those over 80 years of age, may help to motivate the population at large to accept the vaccination, especially the elders of our society.…”

Adverse reactions to BNT162b2 mRNA COVID-19 vaccine in medical staffs with a history of allergy

“…In a previous report, the COVID-19 vaccination of hospital staff was performed, and the frequency of adverse reactions was examined according to the presence or absence of allergy (11). They found that subjects with a history of allergy had a significantly higher incidence of adverse reactions after vaccination than those without.…”

Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases

“…According to the currently published literature ( Table 5 ), patients with allergy history apparently had a higher prevalence of local and systemic post-vaccination symptoms compared to subjects with no allergy [ 51 , 54 ]. Specifically, one large study compared the clinical features of patients with allergies receiving the BNT162b2 vaccine with those of subjects from the general population who had no allergy (but could have other comorbidities) and found that allergic subjects had higher rates of local pain (86% vs. 80% in controls), local erythema (17% vs. 11%) and local swelling (19% vs. 13%) throughout the vaccination cycle.…”

“…Specifically, one large study compared the clinical features of patients with allergies receiving the BNT162b2 vaccine with those of subjects from the general population who had no allergy (but could have other comorbidities) and found that allergic subjects had higher rates of local pain (86% vs. 80% in controls), local erythema (17% vs. 11%) and local swelling (19% vs. 13%) throughout the vaccination cycle. The same study reported higher rates of systemic symptoms such as fatigue (50% vs. 45%) and arthralgia (32% vs. 26%) along with headache (42% vs. 37%), gait disturbances (2% vs. <1%), vomit (3% vs. 1%) and palpitations (7% vs. 4%) in allergic individuals compared to non-allergic individuals after the second dose of the BNT162b2 vaccine [ 54 ]. Another study, showed that patients with autoimmunity or immunodeficiency who also had an allergic background had a higher likelihood of experiencing local and constitutional symptoms with the BNT162b2 vaccine [ 51 ].…”

“…No data are currently available about the differential clinical profile of allergic subjects in comparison with proper healthy controls (although the majority of patients in ref. [ 54 ] reported no comorbidities).…”