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Monitored COVID-19 mRNA vaccine second doses for people with adverse reactions after the first dose
Megan C Gallagher1, Sarah Haessler1, Elizabeth Pecoy-Whitcomb2
1From the Division of Infectious Diseases, University of Massachusetts Medical School-Baystate, Springfield, Massachusetts.
Abstract:
Background: After Emergency Use Authorization of the coronavirus disease 2019 (COVID-19) vaccines, guidance was provided by the Centers for Disease Control and Prevention that persons with an immediate allergic reaction to a messenger RNA (mRNA) COVID-19 vaccine should be evaluated by an allergist/immunologist before receipt of the second dose. Methods: In vaccinating health-care personnel, we referred those with significant reactions to allergy/immunology specialists so that they could safely receive the second dose. Results: We found that many reactions after the first dose were nonallergic but could be debilitating and a barrier to the second dose. We created a protocol of premedications to allow health-care personnel to safely receive their second mRNA COVID-19 vaccine dose. Conclusion: This protocol is adaptable and can be used in settings where allergy/immunology referral is not immediately available.
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