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1/Updated #allergy data and guidance from @CDCgov on #anaphylaxis & mRNA #COVID19vaccines. Data now cover Dec 14-Jan 18, & include 66 anaphylaxis cases (47 @pfizer & 19 @moderna_tx ) #vaccination #COVID19 #AIMedEd #IDTwitter #MedTwitter https://jamanetwork.com/journals/jama/fullarticle/2776557
2/ Overall estimated #COVID19Vaccine #anaphylaxis incidence through passive reporting (VAERS and V-safe) to @CDCgov is very very low: 4.7 cases/mil doses @pfizer and 2.5 cases/mil @moderna_tx. @pfizer estimate is now lower than before (11.1 cases/mil) https://www.cdc.gov/mmwr/volumes/70/wr/mm7002e1.htm?s_cid=mm7002e1_w
3/Who is getting #anaphylaxis to #COVID19vaccines?: Median age ~40, 95% female, allergy history present in 79%, anaphylaxis history present in 32%. Although most cases (82%) were a 1st dose reaction, #anaphylaxis also has occurred with the 2nd dose in 5 individuals.
4/What is #anaphylaxis timing? Median time from vaccine administration to symptom onset was 10min (range <1min to >19hrs). 76% had symptoms within recommended/usual 15min observation. @CDCgov advises 30min observation for prior anaphylaxis & 86% of cases had onset within 30min.
5/What are the #anaphylaxis outcomes? 92% received epinephrine, 48% hospitalized, & 11% temporary assistance breathing. For 61 complete cases, ALL recovered (=0 anaphylaxis deaths). All vaccination sites given guidance for #anaphylaxis. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/managing-anaphylaxis.html
6/What does this mean for the 33% of US with #drugallergy? It means you CAN receive these vaccines safely provided there is NO immediate or severe allergic reaction history to (1) mRNA #COVID19vaccines, (2) polyethylene glycol (PEG), or (3) polysorbates
7/Newsworthy changes also @CDCgov includes the vital role of the #allergist for assessing individuals with potential contraindication and precautions to #vaccination. Find an #allergist near you here: https://allergist.aaaai.org/find/
https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html /end
https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html /end
@NeilFlochMD @drjessigold @ericashenoy @EricMacyMD @PaulSaxMD @PAallergy @EricTopol @hboucher3 @CDCDirector @ErinSandersNP @SandyNelsonMD @BasgozNesli @mgh_id @MGHAllergy @PaigeWickner @darakass @DrEstherFreeman @choo_ek @CarlosdelRio7 @hboucher3 @BranchWestyn @jabarocas @drJoshS
New @CDCgov guidance on delayed-onset local reactions near the injection site after dose 1: NIETHER a contraindication NOR precaution to getting dose 2 https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html.
