An Assessment of Anaphylaxis Risk Following Moderna COVID-19 Vaccination
BACKGROUND AND PURPOSE:
As of January 10, 2021, approximately 4-million first doses of the Moderna COVID-19 vaccine have been administered in the U.S.
Rare cases of anaphylaxis and other allergic reactions have been reported with the Pfizer-BioNTech COVID-19 vaccine, another mRNA-based vaccine
The CDC COVID-19 response team (MMWR, 2021) reported on cases of allergic reactions, including anaphylaxis, associated with first-dose vaccination of the Moderna vaccine
Vaccine Adverse Event Reporting System (VAERS)
1266 adverse events
108 case reports identified for further review for possible cases of allergic reaction, including anaphylaxis
Anaphylaxis cases: 10 (all women)
Anaphylaxis rate: 2.5 cases per million doses
Median age: 47 years (range 31 to 63 years)
Cases with history of allergies or allergic reactions: 9
5 had a history of anaphylaxis
Median interval from vaccine receipt to symptom onset: 7.5 minutes (range 1 to 45 minutes) | 9 cases within 15 minutes
All patients received IM epinephrine and 6 hospitalized
5 ICU | 4 intubated
Follow-up (available in 8 cases)
All recovered or discharged home
Other allergic reactions and adverse events
Other non-anaphylaxis allergic reactions
43 cases within 0 to 1 day risk window
60% (26/43) classified as nonserious
Commonly reported symptoms: Pruritus | Rash | Itchy sensations in the mouth and throat | Sensations of throat closure | Respiratory symptoms
Anaphylaxis following the first dose of the Moderna vaccine is very rare, and occurred within 45 minutes of receipt with a median time of 7.5 minutes
The CDC recommends that
Persons with an immediate allergic reaction to the first dose of an mRNA COVID-19 vaccine should not receive additional doses of either of the mRNA COVID-19 vaccines
In addition to screening for contraindications and precautions before administering COVID-19 vaccines, vaccine locations should have the necessary supplies and trained staff members available to manage anaphylaxis, implement postvaccination observation periods, immediately treat persons experiencing anaphylaxis signs and symptoms with intramuscular injection of epinephrine, and transport patients to facilities where they can receive advanced medical care
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