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Relationship between pre-existing allergies and anaphylactic reactions post mRNA COVID-19 vaccine administration
Aditya P Desai1, Aryan P Desai2, Gregory J Loomis1
1Indiana University School of Medicine, West Lafayette, IN, USA.
Abstract:
Two mRNA vaccines for COVID-19, Pfizer-BioNTech and Moderna, are approved for emergency use in the United States. After their approval and dosing in millions of recipients, reports of anaphylaxis began to appear in the Vaccine Adverse Reporting System (VAERS). Here we provide an analysis of the relationship between prior history of allergy and/or anaphylaxis and anaphylaxis rates following the administration of mRNA COVID-19 vaccines. Overall reported incidence of anaphylaxis was estimated to be rare at 4.2 cases per million doses. It appeared that the relative incidence of anaphylaxis following administration of these COVID-19 vaccines was two and seven times higher for recipients with a prior history of allergies and/or anaphylaxis, respectively. This report provides valuable metrics to make evidence-based decisions for subjects with pre-existing allergic conditions receiving a COVID-19 mRNA vaccine.
Insights
Anaphylaxis after mRNA COVID-19 vaccines is rare. However, individuals with a history of allergies or anaphylaxis experienced higher rates, informing vaccination decisions for allergic populations.
Area of Science:
- Immunology
- Vaccinology
- Public Health
Background:
- mRNA COVID-19 vaccines (Pfizer-BioNTech, Moderna) are approved for emergency use.
- Post-authorization surveillance identified anaphylaxis reports in the Vaccine Adverse Reporting System (VAERS).
Purpose of the Study:
- To analyze the relationship between a history of allergy/anaphylaxis and anaphylaxis rates after mRNA COVID-19 vaccination.
- To provide data for evidence-based decision-making regarding vaccination in individuals with allergic conditions.
Main Methods:
- Analysis of anaphylaxis reports in the Vaccine Adverse Reporting System (VAERS).
- Calculation of anaphylaxis incidence rates stratified by prior allergy/anaphylaxis history.
Main Results:
- Overall anaphylaxis incidence was estimated at 4.2 cases per million doses.
- Relative incidence of anaphylaxis was 2x higher for recipients with prior allergies and 7x higher for those with prior anaphylaxis.
Conclusions:
- Anaphylaxis following mRNA COVID-19 vaccination is rare.
- Individuals with a history of allergies or anaphylaxis have a higher relative risk of experiencing anaphylaxis post-vaccination.
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