COVID-19 vaccine-associated anaphylaxis: A statement of the World Allergy Organization Anaphylaxis Committee

• Type of Material: Article
• Authors: Paul J. Turner, National Heart and Lung Institute; Ignacio J. Ansotegui, Hospital Quironsalud Bizkaia; Dianne E. Campbell, University of Sydney School of Medicine; Victoria Cardona, Hospital Universitari Vall d'Hebron; Motohiro Ebisawa, National Hospital Organization Sagamihara National Hospital; Yehia El-Gamal, Ain Shams University; Stanley Fineman, Emory University; Mario Geller, Academy of Medicine of Rio de Janeiro; Alexei Gonzalez-Estrada, Mayo Clinic in Jacksonville, Florida; Paul A. Greenberger, Northwestern University Feinberg School of Medicine; Agnes S. Y. Leung, Prince of Wales Hospital Hong Kong; Michael E. Levin, University of Cape Town; Antonella Muraro, Azienda Ospedale Università Padova; Mario Sánchez Borges, Centro Medico Docente La Trinidad; Gianenrico Senna, Università degli Studi di Verona; Luciana K. Tanno, Hospital Sirio-Libanês; Bernard Yu-Hor Thong, Tan Tock Seng Hospital; Margitta Worm, Charité – Universitätsmedizin Berlin
• Language: English
• Date: 2021-02-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Author(s). Published by Elsevier Inc. on behalf of World Allergy Organization.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.waojou.2021.100517
• Title of Journal or Parent Work: World Allergy Organization Journal
• Volume: 14
• Issue: 2
• Grant/Funding Information: None.
• Keywords: COVID-19; Anaphylaxis; Child health; Dermatology; Allergy; Immunology; Pediatrics
• Research Categories: Health Sciences, Human Development; Health Sciences, Immunology; Health Sciences, Public Health

Abstract

Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Vaccines often cause adverse events; however, the vast majority of adverse events following immunization (AEFI) are a consequence of the vaccine stimulating a protective immune response, and not allergic in etiology. Anaphylaxis as an AEFI is uncommon, occurring at a rate of less than 1 per million doses for most vaccines. However, within the first days of initiating mass vaccination with the Pfizer-BioNTech COVID-19 vaccine BNT162b2, there were reports of anaphylaxis from the United Kingdom and United States. More recent data imply an incidence of anaphylaxis closer to 1:200,000 doses with respect to the Pfizer-BioNTech vaccine. In this position paper, we discuss the background to reactions to the current COVID-19 vaccines and relevant steps to mitigate against the risk of anaphylaxis as an AEFI. We propose a global surveillance strategy led by allergists in order to understand the potential risk and generate data to inform evidence-based guidance, and thus provide reassurance to public health bodies and members of the public.