Prevalence of Allergic Reactions After Pfizer-BioNTech COVID-19 Vaccination Among Adults With High Allergy Risk

Shavit, Ronen; Maoz-Segal, Ramit; Iancovici-Kidon, Mona; Offengenden, Irena; Yahia, Soad Haj; Maayan, Diti Machnes; Lifshitz-Tunitsky, Yulia; Niznik, Stanley; Frizinsky, Shirly; Deutch, Michal; Elbaz, Eti; Genaim, Hosney; Rahav, Galia; Levy, Itzchak; Belkin, Anna; Regev‐Yochay, Gili; Afek, Arnon; Agmon‐Levin, Nancy

doi:10.1001/jamanetworkopen.2021.22255

Cited by 73 publications

(110 citation statements)

References 20 publications

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“…However, none of them developed life-threatening anaphylaxis. A recent research in JAMA network states that even highly allergic individuals can take Pfizer vaccine; however vaccination should be strictly under medical supervision and requires special precautions [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Adverse events following the first dose of Covishield (ChAdOx1 nCoV-19) vaccination among health workers in selected districts of central and western Nepal: A cross-sectional study

Subedi¹,

Paudel²,

Regmi³

et al. 2021

PLoS ONE

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Introduction The study aimed at exploring the adverse events following immunization (AEFI) and their incidences among health workers in three different districts of central and western Nepal following the first dose of Covishield vaccine,. It also aimed at studying the association of AEFI with demographic and clinical characteristics of vaccinees, pre-vaccination anxiety level and prior history of COVID-19 infection (RT- PCR confirmed) status. Materials and methods This was a cross-sectional study carried out via face-to-face or telephonic interview among 1006 health workers one week after receiving their first dose of the Covishield vaccine. Incidence of adverse events was calculated in percentage while Chi-square Test was used to check the association of AEFI with independent variables. Logistic regression was used to find out the adjusted odd’s ratio at 95% CI. Results Incidence of AEFI was 79.8% with local and systemic AEFI being 68.0% and 59.7% respectively. Injection site tenderness was the commonest manifestation. Local and systemic symptoms resolved in less than one week among 96.8% and 98.7% vaccinees respectively. Females were more likely to develop AEFI than males (AOR = 1.7, 95% CI = 1.2–2.4). Vaccinees aged 45–59 years were 50% less likely to develop AEFI as compared to those aged less than 30 years (AOR 0.5, 95% CI = 0.3–0.8). Most of the vaccinees had not undergone RT-PCR testing for COVID-19 (59.8%). Those who were not tested for COVID-19 prior were 1.5 odds more likely to develop AEFI compared to those who were negative (AOR = 1.5, 95% CI = 1.1–2.1). Conclusion More than two-third of the vaccinees developed one or more forms of adverse events, but most events were self-limiting. Females and young adults were more prone to develop AEFI.

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Section: Discussionmentioning

confidence: 99%

Adverse events following the first dose of Covishield (ChAdOx1 nCoV-19) vaccination among health workers in selected districts of central and western Nepal: A cross-sectional study

Subedi¹,

Paudel²,

Regmi³

et al. 2021

PLoS ONE

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“… 9 , 28 However, a recent study of 429 highly allergic individuals who received the Pfizer-BioNTech vaccine under medical observation identified a much higher rate of minor allergic reactions (1.4%) and anaphylaxis (0.7%). 29 Past vaccine reactions have largely been attributed to excipients rather than to vaccine active ingredients. 13 , 30 The cohort in the present study included 217 employees with a history of a severe allergic reaction to an injectable medication or a vaccine and 9 employees with a history of severe allergic reaction to PEG.…”

Section: Discussionmentioning

confidence: 99%

Association of Self-reported High-Risk Allergy History With Allergy Symptoms After COVID-19 Vaccination

Robinson

Patel

et al. 2021

JAMA Netw Open

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IMPORTANCE Allergic history in individuals with confirmed anaphylaxis to a messenger RNA (mRNA) COVID-19 vaccine is common. However, the risk factors for allergy symptoms after receiving the vaccine are unknown. OBJECTIVETo assess the association between self-reported history of high-risk allergy and selfreported allergic reactions after mRNA COVID-19 vaccination of health care employees. DESIGN, SETTING, AND PARTICIPANTSThis cohort study obtained demographic, medical, and vaccine administration data of employees of Mass General Brigham from the institutional electronic health record. Employees who received at least 1 dose of an mRNA COVID-19 vaccine between December 14, 2020, and February 1, 2021, and who completed at least 1 postvaccination symptom survey in the 3 days after vaccination were included.EXPOSURES Self-reported history of high-risk allergy, defined as a previous severe allergic reaction to a vaccine, an injectable medication, or other allergen. MAIN OUTCOMES AND MEASURESThe primary outcome was 1 or more self-reported allergic reactions in the first 3 days after dose 1 or dose 2 of an mRNA COVID-19 vaccine. Multivariable log binomial regression was used to assess the association between allergic reactions and high-risk allergy status. RESULTS A total of 52 998 health care employees (mean [SD] age, 42 [14] years; 38 167 women [72.0%]) were included in the cohort, of whom 51 706 (97.6%) received 2 doses of an mRNA COVID-19 vaccine and 474 (0.9%) reported a history of high-risk allergy. Individuals with vs without a history of high-risk allergy reported more allergic reactions after receiving dose 1 or 2 of the vaccine (11.6% [n = 55] vs 4.7% [n = 2461]). In the adjusted model, a history of high-risk allergy was associated with an increased risk of allergic reactions (adjusted relative risk [aRR], 2.46; 95% CI, 1.92-3.16), with risk being highest for hives (aRR, 3.81; 95% CI,) and angioedema (aRR, 4.36; 95% CI,.CONCLUSIONS AND RELEVANCE This cohort study found that self-reported history of high-risk allergy was associated with an increased risk of self-reported allergic reactions within 3 days of mRNA COVID-19 vaccination. However, reported allergy symptoms did not impede the completion of the 2-dose vaccine protocol among a cohort of eligible health care employees, supporting the overall safety of mRNA COVID-19 vaccine.

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“…There is an increase in reactogenic symptoms, including injection-site reactions, myalgia, headache, fever, fatigue, and in some cases, a transient rash. As seen in local postvaccine patients, mucocutaneous manifestations were largely mild and self-limiting, and did not correlate with the reproducibility nor severity of symptoms following next dose of vaccination [ 9 10 ]. In fact, proceeding with a second dose has been shown to be safe even in more severe reactions and cases of anaphylaxis [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…Precautions for vaccine-naïve individuals have been reviewed and updated by multiple healthcare authorities around the world, as emerging evidence shows a lack of association between allergic conditions with risk of developing vaccine-associated allergic reactions [ 10 ]. Our local study similarly found that a history of anaphylaxis, multiple food allergies, and drug allergies were not associated with higher risk of vaccine-associated allergies.…”

Section: Discussionmentioning

confidence: 99%

Updated consensus statements on COVID-19 Vaccine Allergy Safety in Hong Kong

Chiang

Leung

et al. 2022

Asia Pacific Allergy

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Due to global concerns over coronavirus disease 2019 (COVID-19) vaccine-associated allergic reactions; the Hong Kong Institute of Allergy (HKIA) formulated an initial set of consensus statements (CS) on COVID-19 Vaccine Allergy Safety (VAS) in early 2021. Following accumulation of both local and international experience on and COVID-19 VAS, the HKIA task force reformed to update the Hong Kong consensus on COVID-19 VAS. A nominated task force of experts managing patients with drug and vaccine allergies in Hong Kong formulated the updated CS by unanimous decision. A total of 9 new statements were established. Individuals with history of food allergies and anaphylaxis unrelated to the components of COVID-19 vaccines do not require allergist review prior to vaccination. Individuals with history suspicious of an excipient allergy may now be vaccinated with a non-PEG containing vaccine without prior allergist assessment. Individuals with suspected mild allergic reactions following prior COVID-19 vaccination can proceed with the next dose. Only individuals who present with immediate-type allergic reaction with systemic symptoms or more severe nonimmediate type reactions should defer their next dose until allergist review. The remaining statements regarding adequate safety during vaccination and advocation for legislative changes regarding excipient disclosure in Hong Kong remained unchanged from the prior CS. The updated CS are updated in accordance with local and international experience thus far and serve as guidance for local frontline healthcare providers to further promote safe COVID-19 vaccine uptake in Hong Kong.

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Prevalence of Allergic Reactions After Pfizer-BioNTech COVID-19 Vaccination Among Adults With High Allergy Risk

Cited by 73 publications

References 20 publications

Adverse events following the first dose of Covishield (ChAdOx1 nCoV-19) vaccination among health workers in selected districts of central and western Nepal: A cross-sectional study

Adverse events following the first dose of Covishield (ChAdOx1 nCoV-19) vaccination among health workers in selected districts of central and western Nepal: A cross-sectional study

Association of Self-reported High-Risk Allergy History With Allergy Symptoms After COVID-19 Vaccination

Updated consensus statements on COVID-19 Vaccine Allergy Safety in Hong Kong

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