Stay Vigilant for Anaphylaxis in Patients Who’ve Received COVID-19 Vaccine

Both the Pfizer and Moderna COVID-19 vaccines seem to be eliciting a higher-than-expected rate of anaphylaxis, according to an article just published by Morbidity and Mortality Weekly Report. While the rate of allergic reaction is roughly 10 times greater than it is for flu vaccine, the authors conclude that the incidence could still be called “rare” (21 cases out of 1.9 million doses given as of December 23, 2020) and that the benefits of receiving the vaccine outweigh the risks. Further, no related deaths have been reported. Of note, 18 of the cases of anaphylaxis occurred in patients with documented allergies or a history of allergic reactions to drugs, medical products, food, or insect stings; seven had experienced anaphylaxis, specifically. The two take-home points for urgent care providers are 1) to ask patients about any history of reaction to vaccines or food items and 2) to recommend that patients who do have such a history stick around for at least 30 minutes for observation after receiving the vaccine. Median time for symptom onset after receiving the vaccine reflected in the MMWR data was 13 minutes.