Evaluation of the Autoimmunity and Preexisting Risky Conditions for Hypersensitivity Reactions to COVID-19 Vaccines

Abstract

Introduction: The role of autoimmunity and other preexisting risky conditions in hypersensitivity reactions (HSRs) to COVID-19 vaccines seems unclear. The aim of the study was to investigate the autoimmunity and preexisting risky conditions in HSRs to COVID-19 vaccines. Methods: The patients aged ≥18 years with a history of HSR to CoronaVac or Pfizer-BioNTech COVID-19 vaccines within 24 h in 2 tertiary centers were assessed. The patients were divided according to the type of vaccine which they showed immediate-type (<4 h) HSR to (group A1 for CoronaVac and group B1 for Pfizer-BioNTech). Equal number of subjects who did not show HSR to two doses of either CoronaVac or Pfizer-BioNTech was recruited into the study as control groups (group A2 for CoronaVac and group B2 for Pfizer-BioNTech). The autologous serum skin test (ASST) was performed on patient and control groups. Later, the demographic, clinical, and laboratory features were compared between groups. Results: A total number of 27 patients were included in the study. Subjects with chronic spontaneous urticaria (CSU) were more frequent in group B1 than in group B2 (p:0.041). In addition to CSU, the presence of HSRs to drugs was higher in group A1 than in A2 (both p:0.007). The presence of autoimmunity and autoimmune diseases, positivity of antithyroid peroxidase antibody, and ASST were less in group A2 than in A1 (p:0.015, p:0.048, p:0.048, and p:0.037). Additionally, COVID-19 infection history was less in group A2 than in A1 (p:0.037). Discussion/Conclusion: Type IIb autoimmunity seems to play a role in immediate type HSRs to the CoronaVac vaccine as previously shown in autoimmune CSU and multidrug hypersensitivity.

Clinical effects of COVID-19 vaccines on chronic spontaneous urticaria patients: a study on two Turkish centers

“…In a study, authors mentioned that atopic dermatitis and thyroid diseases are risk factors for immediate hypersensitivity reactions (IHSR) after COVID-19 vaccinations. Our results do not support this relationship ( 11 ). All patients with urticarial exacerbation after vaccinations were treated with systemic steroids (0.5 mg–1 mg/kg, 5–10 days) and AH.…”

“…Fever, fatigue, and headache are also commonly reported systemic reactions (3)(4)(5). The relationship between CSU and vaccines is reported in the literature (6), however, some publications have given different results about the effects of COVID-19 vaccines on patients with CSU (7)(8)(9)(10)(11)(12).…”

Reações de hipersensibilidade a vacinas

“…Hypersensitivity reactions were rare, occurring at a frequency of 1/1000 to 1/100. 57,58 Of the 221 participants of a Turkish trial, 62 (28.1%) reported allergic or skin reactions (injection site pain and/or inflammatory reactions) temporally related to the CoronaVac vaccine. Of the 62 patients who had skin reactions, 25 (11.3%) had no personal or family history of allergy, while the remaining 37 reported a history of allergy.…”

Hypersensitivity reactions to vaccines

“…Hypersensitivity reactions were rare, occurring at a frequency of 1/1000 to 1/100. 57,58 Of the 221 participants of a Turkish trial, 62 (28.1%) reported allergic or skin reactions (injection site pain and/or inflammatory reactions) temporally related to the CoronaVac vaccine. Of the 62 patients who had skin reactions, 25 (11.3%) had no personal or family history of allergy, while the remaining 37 reported a history of allergy.…”