Second COVID-19 mRNA vaccine dose found safe following allergic
reactions to first dose
Allergists encourage patients to complete their vaccination series

Date:
July 26, 2021
Source:
Massachusetts General Hospital
Summary:
A new study reports that among individuals who had an allergic
reaction to their first mRNA COVID-19 vaccine dose, all who went
on to receive a second dose tolerated it. Even some who experienced
anaphylaxis following the first dose tolerated the second dose.



FULL STORY ==========================================================================
In a multi-hospital analysis of individuals who experienced an allergic reaction to their first mRNA COVID-19 vaccine dose, all patients who
went on to receive a second dose tolerated it without complications. The research, which was led by allergists at Massachusetts General Hospital
(MGH) and is published in JAMA Internal Medicine, indicates that a first
dose reaction to COVID-19 vaccination should not keep people from getting
a second dose.


========================================================================== Allergic reactions after mRNA COVID-19 vaccinations have been reported
to be as high as 2%, with anaphylaxis -- a life-threatening whole-body
allergic reaction -- occurring in up to 2.5 per 10,000 people. To examine whether it's safe to proceed with a second mRNA COVID-19 vaccine dose
after a dose one reaction, investigators from MGH, Vanderbilt University Medical Center, University of Texas Southwestern Medical Center and
Yale School of Medicine combined data from patients who sought allergy specialist care at their hospitals after a reaction to their first mRNA COVID-19 vaccine dose. "These reactions could include symptoms such as
itching or hives or flushing. The patients included were all advised
by allergy specialists after their dose one reaction," explains co-lead
author Matthew S. Krantz, MD, of Vanderbilt University Medical Center.

Among 189 patients, 32 (17%) experienced anaphylaxis after their first
dose of mRNA COVID-19 vaccine. A total of 159 patients (84%) went on
to receive a second dose. All 159 patients, including 19 individuals
who had experienced anaphylaxis following the first dose, tolerated the
second dose. Thirty-two patients (20%) reported immediate and potentially allergic symptoms associated with the second dose that were self-limited,
mild, and/or resolved with antihistamines alone.

"One important point from this study is that these immediate onset mRNA
vaccine reactions may not be mechanistically caused by classic allergy,
called immediate hypersensitivity or Ig-E-mediated hypersensitivity. For classic allergy, re-exposure to the allergen causes the same or even
worse symptoms," says co-senior author Kimberly G. Blumenthal, MD, MSc, co-director of the Clinical Epidemiology Program within MGH's Division
of Rheumatology, Allergy and Immunology.

The study's findings suggest that it's safe for most individuals to
receive a second dose of the mRNA COVID-19 vaccine, notes co-senior
author Aleena Banerji, MD, clinical director of the Allergy and Clinical Immunology Unit at MGH. "After first dose reactions, allergy specialists
may be useful to help guide risk/benefit assessments and assist with
completion of safe vaccination," she says.

This study was funded by the National Institutes of Health and MGH.

========================================================================== Story Source: Materials provided by Massachusetts_General_Hospital. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Matthew S. Krantz, Jason H. Kwah, Cosby A. Stone, Elizabeth
J. Phillips,
Gilbert Ortega, Aleena Banerji, Kimberly G. Blumenthal. Safety
Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in
Patients With Immediate Reactions to the First Dose. JAMA Internal
Medicine, 2021; DOI: 10.1001/jamainternmed.2021.3779 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/07/210726113945.htm

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