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Low risk of second allergic reaction to SARS-CoV-2 vaccines
Clinical Question
What is the risk of anaphylaxis in patients who had an allergic reaction to a previous SARS-CoV-2 vaccine?
Bottom line
Under careful observation, patients who have had a nonanaphylactic allergic reaction to a first SARS-CoV-2 vaccine can receive a second vaccination with a low risk of anaphylaxis. 3a
Reference
Study design: Meta-analysis (other)
Funding: Unknown/not stated
Setting: Various (meta-analysis)
Synopsis
The investigators searched 4 databases and they found 22 case reports or case series that investigated the likelihood of an immediate second allergic reaction in patients with a prior allergic reaction to a SARS-CoV-2 vaccine. Two researchers independently screened articles for inclusion and extracted data. They identified a total of 1366 patients with an immediate (within 4 hours) allergic reaction to their first vaccine. Only 6 patients developed a severe immediate allergic reaction after their second vaccination (0.16%; 95% CI 0.01% - 2.94%) and 232 (13.7%) developed mild symptoms. Of the 78 patients who had a severe reaction after their first dose, 4 (4.9%) had a second severe reaction, and 15 (9.5%) had mild symptoms. No patients died. Neither premedication nor graduated vaccine design affected the likelihood of a second reaction.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
COVID
In this case I will the decision to patient’s discretion.
Low risk of second allergic reaction to SARS-CoV-2 vaccines
Very reassuring! Do we have to advice same vaccine ?
second dose of covid vaccine
low risk of anaphylaxis with 2nd dose if pt had non anaphylactic rx to the first dose