Urticaria, angioedema events account for 13% of COVID-19 vaccine reactions
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PHOENIX — Urticaria and/or angioedema events comprised 13% of the adverse reports from clinicians after mRNA vaccinations for COVID-19, according to a presentation at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
Noting that hypersensitivity reactions were reported after mass COVID-19 vaccination events were implemented, evidence-based information about side effects can combat vaccine hesitancy, the researchers said.
The researchers abstracted urticaria and/or angioedema (U/AE) events reported to the Massachusetts General Hospital and Harvard Medical School COVID-19 Vaccine Allergy Case Registry between Feb. 13, 2021, and Oct. 22, 2021.
“The study primary investigator, Kimberly Blumenthal, MD, MSc, from Massachusetts General Hospital, along with her research team established the COVID-19 Vaccine Allergy Case Registry for clinicians and patients to enter data on vaccine-related reactions,” Sara Anvari, MD, MSc, assistant professor of pediatrics in the section of allergy and immunology at Baylor College of Medicine, told Healio.
“The registry was designed to collect and share reports of COVID-19 vaccine reactions, promote improved care and management and advance knowledge on COVID-19 vaccine reactions,” said Anvari, who also is director of clinical trials in the Food Allergy Program at Texas Children’s Hospital.
The reports included 455 unique patients from 44 U.S. states, including 58 patients (mean age, 49 years; age range, 13-85 years; 84% female; 76% white) who experienced U/AE events after vaccination.
Most of the U/AE events occurred after the first dose (n = 43; 74%) of the Pfizer-BioNTech and Moderna COVID-19 vaccines equally (n = 29; 50%). The U/AE events began 4 hours or sooner after vaccination in 35% (n = 20) of the cases, from more than 4 hours to 24 hours in 19% (n = 11) of cases, and more than 24 hours later in 47% (n = 27) of cases.
Also, 17% (n = 10) of the patients had a history of chronic U/AE, and 40% (n = 23) had other atopic comorbidities such as nasal allergies, asthma and eczema. Antihistamines were used to treat 67% (n = 39) of the patients, 5% (n = 3) received epinephrine and 31% (n = 18) received oral corticosteroids.
Whereas 3% (n = 2) required hospitalization, 24% (n = 14) were treated in the ED and 26% (n = 15) were treated at home. Also, according to Anvari, the U/AE events did not result in any ICU admissions or deaths, and 20% of patients did not require treatment at all.
Based on the timing of the onset of the U/AE and the benign course most cases followed, the researchers concluded that many U/AE events that followed COVID-19 vaccination should not contraindicate future doses.
The researchers aim to obtain more data about these events following the two-dose vaccine series and further evaluate their outcomes following boosters.
“More research is needed to understand the pathophysiology leading to the urticaria and angioedema events following COVID-19 vaccination,” Anvari said.
The registry is still open to both clinicians and patients, and data can be entered online.