Low Risk Seen for Second Allergic Reaction to mRNA COVID-19 Vaccine

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Of 1366 patients with immediate allergic reaction to first dose, six developed severe immediate allergic reaction after second dose

HealthDay News — For patients with an allergic reaction to their first dose of mRNA SARS-CoV-2 vaccination, the risk for repeated immediate allergic and severe immediate allergic reactions associated with a second dose is low, according to a review published online February 21 in JAMA Internal Medicine.

Derek K. Chu, MD, PhD, from McMaster University in Hamilton, Ontario, Canada, and colleagues conducted a systematic review to examine the risk for severe immediate allergic reactions to a second dose of SARS-CoV-2 mRNA vaccine among individuals with an immediate allergic reaction to the first dose. Data were included from 22 studies, with 1366 individuals who had immediate allergic reactions to their first vaccination.

The researchers found that six patients developed severe immediate allergic reactions after their second vaccination (absolute risk, 0.16%) and 1360 (99.84%) tolerated the dose. Overall, 232 patients (13.65%) experienced mild immediate nonsevere symptoms with their second dose. Of the 78 people with severe immediate allergic reactions to their first SARS-CoV-2 mRNA vaccination, four (4.94%) and 15 (9.54%) had a second severe immediate reaction and nonsevere symptoms, respectively. No deaths were reported.

“Although further research is warranted, these findings support the safe revaccination of individuals with an allergic reaction to a first SARS-CoV-2 mRNA vaccine dose in a setting equipped to manage severe allergic reactions, if they were to occur,” the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Pfizer.

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