Development of an Intervention to Reduce Pain and Prevent Syncope Related to Adolescent Vaccination

Kuntz, Jennifer L; Firemark, Alison; Schneider, Jennifer; Henninger, Michelle; Bok, Karin; Naleway, Allison L.

doi:10.7812/tpp/17-136

Cited by 7 publications

(7 citation statements)

References 37 publications

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“…To prevent VVR, hydration (e.g. drinking water), pain management during the procedure, and muscle tension maneuvers have been proposed ( 14 , 15 ). These preventive measures are also effective in treating reflex syncope.…”

Section: Discussionmentioning

confidence: 99%

Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination

et al. 2022

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Coronavirus disease 2019 (COVID-19) has become a pandemic, and vaccines remain the only effective tools available for ending it. However, their side effects, such as syncope, which mimics sudden cardiac death, are serious concerns. We herein report 6 cases of delayed vasovagal syncope and presyncope (VVR) caused by COVID-19 vaccination among 25,530 COVID-19 patients. The prevalence of delayed VVR due to COVID-19 vaccination was 0.026%. In addition, no delayed VVR was found among 17,386 patients who received the influenza vaccine. Delayed VVR is likely to be overlooked if medical staff are not aware of this symptom. This report provides significant information regarding effects of COVID-19 vaccination.

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Section: Discussionmentioning

confidence: 99%

Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination

et al. 2022

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“…Many authors have previously proposed intervention in this matter. 24 , 25 For example, soothing background music has been proposed by Kuntz et al 24 Moreover, exposure-based psychological interventions and applied muscle tension have shown evidence of benefit in the reduction of needle fear in pediatric and adult population. 25 In contrast, drinking water does not seem to be associated with a decrease of postvaccination presyncope in particular in adolescents.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccines associated with vasovagal malaise: A retrospective study in two mass vaccination centers and analysis of the WHO pharmacovigilance database

Chrétien

Stroiazzo

Troussier³

et al. 2022

Human Vaccines & Immunotherapeutics

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The association between COVID-19 vaccines and vasovagal malaise (VVM) has recently been reported in the literature. Our study aimed to describe COVID-19 vaccines associated VVM cases and to identify risk factors of COVID-19 vaccines associated VVM. To this end, we performed a descriptive study of VVM reports associated with COVID-19 vaccines from two French mass COVID-19 vaccination centers. We also extracted reports of VVM associated with all-COVID-19 vaccines in VigiBase®, the World Health Organization (WHO) pharmacovigilance database to analyze demographic data. In the two French mass vaccination center database, 408 entries reported VVM after the standard administration of tozinameran - Pfizer® (1.63/1,000 vaccinated persons). Of these cases, 213 (52.2%) occurred in women, and 193 (47.3%) occurred in the 18–29 year-old (yo) age group. In 232 cases (56.8%), patients had a history of anxiety related to needles or medical visits, 213 (52.2%) reported a fear of COVID-19 vaccination in particular, and 233 (57.1%) had a history of VVM. In VigiBase®, 336,291 notifications of COVID-19 vaccines associated with VVM were identified in the adult population during the period of analysis. The most reported age class was 18–44 years (52.4%), and women represented 71.7% of the reports. Reporting widely differed depending on the country. This study, performed in real-life conditions, highlights that VVM is associated with all-COVID-19 vaccines. Young age and history of anxiety related in young adults could be a triggering factor of vaccines-associated VVM. Further studies are needed to confirm our results.

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“… 24 , 25 , 26 , 27 , 28 We also advise that patients eat at least a small amount of food within 60 minutes before receiving an injection. 29 , 30 Finally, acknowledging that patient and clinician preferences may impact this decision, we advise administration of BPG in patients in the supine position, which limits venous pooling in the lower extremities, and remaining supine for 5 to 10 minutes following injection with slow return to the standing position (Table 2 ).…”

Section: Risk Mitigationmentioning

confidence: 99%

Penicillin Reactions in Patients With Severe Rheumatic Heart Disease: A Presidential Advisory From the American Heart Association

Sanyahumbi¹,

Ali²,

Benjamin³

et al. 2022

JAHA

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Secondary antibiotic prophylaxis with regular intramuscular benzathine penicillin G (BPG) is the cornerstone of rheumatic heart disease management. However, there is a growing body of evidence that patients with rheumatic heart disease who have severe valvular heart disease with or without reduced ventricular function may be dying from cardiovascular compromise following BPG injections. This advisory responds to these concerns and is intended to: (1) raise awareness, (2) provide risk stratification, and (3) provide strategies for risk reduction. Based on available evidence and expert opinion, we have divided patients into low‐ and elevated‐risk groups, based on symptoms and the severity of underlying heart disease. Patients with elevated risk include those with severe mitral stenosis, aortic stenosis, and aortic insuffiency; those with decreased left ventricular systolic dysfunction; and those with no symptoms. For these patients, we believe the risk of adverse reaction to BPG, specifically cardiovascular compromise, may outweigh its theoretical benefit. For patients with elevated risk, we newly advise that oral prophylaxis should be strongly considered. In addition, we advocate for a multifaceted strategy for vasovagal risk reduction in all patients with rheumatic heart disease receiving BPG. As current guidelines recommend, all low‐risk patients without a history of penicillin allergy or anaphylaxis should continue to be prescribed BPG for secondary antibiotic prophylaxis. We publish this advisory in the hopes of saving lives and avoiding events that can have devastating effects on patient and clinician confidence in BPG.

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Development of an Intervention to Reduce Pain and Prevent Syncope Related to Adolescent Vaccination

Cited by 7 publications

References 37 publications

Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination

Delayed Vasovagal Reaction with Reflex Syncope Following COVID-19 Vaccination

COVID-19 vaccines associated with vasovagal malaise: A retrospective study in two mass vaccination centers and analysis of the WHO pharmacovigilance database

Penicillin Reactions in Patients With Severe Rheumatic Heart Disease: A Presidential Advisory From the American Heart Association

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