An Update on COVID-19 Vaccine Related Anaphylaxis: Cases Remain Rare
BACKGROUND AND PURPOSE:
- Initial reporting rates of anaphylaxis in the US
- Moderna: 2.5 cases per million doses (December 14 to 23, 2020)
- Pfizer-BioNTech: 11.1 cases per million doses (December 21 to January 10, 2021)
- Shimabukuro et al. (JAMA, 2021) provide an update regarding anaphylaxis rates following vaccination
METHODS:
- Data sources
- Vaccine Adverse Event Reporting System (VAERS)
RESULTS:
- Doses administered in US between December 14, 2020 and January 18, 2021
- Moderna: 7,581,429 doses
- Pfizer-BioNTech: 9,943,247 doses
- There were 66 total anaphylaxis cases after vaccine administration
- Moderna: 19 total cases
- Reporting rate 2.5 cases per million doses
- Pfizer-BioNTech: 47 total cases
- Reporting rate 4.7 cases per million doses
- Moderna: 19 total cases
- Anaphylaxis case characteristics
- Median (range) minutes to symptom onset
- Moderna: 10 minutes (1 to 45 minutes)
- Pfizer-BioNTech: 10 minutes (<1 minute to 19 hours)
- Occurred in persons with a history of allergic reactions
- Moderna: 84%
- Pfizer-BioNTech: 77%
- Occurred in persons with a history of anaphylaxis
- Moderna: 26%
- Pfizer-BioNTech: 34%
- Median (range) minutes to symptom onset
- No deaths have been reported due to vaccine-related anaphylaxis
CONCLUSION:
- Millions of doses of the Moderna and Pfizer-BioNTech COVID-19 vaccines have been administered in the US
- Anaphylaxis is a rare event
- The reporting rate is 2.5 (Moderna) and 4.7 (Pfizer-BioNTech) cases per million doses
- Immediate epinephrine administration is indicated for all cases of anaphylaxis
- The authors conclude
When considered in the context of morbidity and mortality from COVID-19, the benefits of vaccination far outweigh the risk of anaphylaxis, which is treatable
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