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In a multi-hospital analysis of people who had experienced an allergic reaction to their first dose of the covid-19 vaccine based on messenger RNA (mRNA) technology,

all those who received a second dose tolerated it without complications

. The research, led by allergists at Massachusetts General Hospital (MGH) and just published in

JAMA Internal Medicine

, indicates that a first-dose reaction to the covid-19 vaccine should not prevent people from receiving a second dose.

The

allergic reactions

after administration of a vaccine with a mRNA product against covid-19 are estimated at

2% of vaccinees

, and

anaphylaxis

, up to

2.5 in 10,000 people

.

To

examine whether it is safe to give a second dose

of this type of vaccine

after a reaction to the first

dose, a team of researchers from MGH, Vanderbilt University Medical Center, University of Texas Southwestern Medical Center and Yale School of Medicine combined

data from patients who sought care from an allergist

at their hospitals for a reaction to a first dose.

"These reactions included symptoms such as

itching

,

hives

or

redness

. All included patients were counseled by allergy specialists after their reaction to the first dose," explains co-lead author

Matthew S. Krantz

of Vanderbilt University Medical Center.

Among

189 vaccinees

studied, 32 (

17%

) experienced

anaphylaxis

after their first dose of vaccine.

A total of 159 patients (84%) received the second dose.

All 159 patients, including 19 individuals who had experienced anaphylaxis with the first, tolerated the second dose well

.

Thirty-two patients (

20%

) reported

immediate and allergic symptoms

associated with the second dose, although these were mild and self-limited, or resolved with antihistamines.

Reactions

"An important aspect of this study is that these reactions to the immediate-onset mRNA vaccine may not be mechanically caused by the classic allergy, called

immediate

hypersensitivity or IgE-mediated hypersensitivity

. For classic allergy, re-exposure to the allergen causes the same or even worse symptoms, "says co-lead author

Kimberly G. Blumenthal

, co-director of the Clinical Epidemiology Program within MGH's Division of Rheumatology, Allergy and Immunology.

The study findings suggest that it

is safe for most people to receive a second dose of the mRNA vaccine

, says another study co-lead author,

Aleena Banerji

, who is clinical director of MGH's Allergy and Clinical Immunology Unit.

"After reactions to the first dose, allergy specialists can be helpful in helping guide benefit / risk assessments and safely complete a vaccination."

According to the criteria of The Trust Project

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