Managing Patients Experiencing Adverse Events After COVID-19 Vaccination

A recent study of adverse events following immunization (AEFI) with the COVID-19 vaccine demonstrates an approach for evaluating and managing patients with AEFIs during a pandemic. Results of the study were presented at the American College of Allergy, Asthma, and Immunology (ACAAI) Annual Scientific Meeting, held in New Orleans, LA, November 4 to 8, 2021.

Efforts to vaccinate the population during the COVID-19 pandemic have highlighted the problem of AEFI and their potential to cause vaccine hesitancy. Researchers sought to determine effective methods for addressing this problem through a retrospective review of 25 patients referred to the Walter Reed National Military Medical Center Allergy Clinic for AEFI following receipt of an MRNA COVID-19 vaccine between December 2020 and June 2021.

Of the 25 patients studied, 23 experienced adverse effects after their first vaccine dose, with 14 of these experiencing possible hypersensitivity reaction. Of those 14, 6 underwent skin testing, with no positive results. After appropriate specialist evaluation, 15 patients underwent vaccine challenge and experienced old mild symptoms. Ultimately, 2 patients were advised not to receive the second dose and 6 patients chose not to receive the second dose.

Investigators concluded, “This study provides an approach on how to evaluate and manage AEFI during a pandemic, demonstrate the limitations of current testing, and provide insight on how to counsel patients considering future doses.”

Reference

St. Clair B, Hoffman D, Lee R, Montgomery J. MRNA COVID-19 vaccine adverse events following immunization: should you recommend the second dose? Presented at: American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting; November 4-8, 2021; New Orleans, LA. Abstract A001.