Monitored COVID-19 mRNA vaccine second doses for people with adverse reactions after the first dose
Background:
After Emergency Use Authorization of the coronavirus disease 2019 (COVID-19) vaccines, guidance was provided by the Centers for Disease Control and Prevention that persons with an immediate allergic reaction to a messenger RNA (mRNA) COVID-19 vaccine should be evaluated by an allergist/immunologist before receipt of the second dose.
Methods:
In vaccinating health-care personnel, we referred those with significant reactions to allergy/immunology specialists so that they could safely receive the second dose.
Results:
We found that many reactions after the first dose were nonallergic but could be debilitating and a barrier to the second dose. We created a protocol of premedications to allow health-care personnel to safely receive their second mRNA COVID-19 vaccine dose.
Conclusion:
This protocol is adaptable and can be used in settings where allergy/immunology referral is not immediately available.
After Emergency Use Authorization of the coronavirus disease 2019 (COVID-19) vaccines, guidance was provided by the Centers for Disease Control and Prevention that persons with an immediate allergic reaction to a messenger RNA (mRNA) COVID-19 vaccine should be evaluated by an allergist/immunologist before receipt of the second dose.
Methods:
In vaccinating health-care personnel, we referred those with significant reactions to allergy/immunology specialists so that they could safely receive the second dose.
Results:
We found that many reactions after the first dose were nonallergic but could be debilitating and a barrier to the second dose. We created a protocol of premedications to allow health-care personnel to safely receive their second mRNA COVID-19 vaccine dose.
Conclusion:
This protocol is adaptable and can be used in settings where allergy/immunology referral is not immediately available.
Keywords: COVID-19; allergy evaluation; mRNA vaccine; vaccine reactions
Document Type: Research Article
Affiliations: 1: From the Division of Infectious Diseases, University of Massachusetts Medical School—Baystate, Springfield, Massachusetts; 2: Employee Health Services, Baystate Health, Springfield, Massachusetts; and 3: Division of Allergy and Immunology, University of Massachusetts Medical School—Baystate, Springfield, Massachusetts
Publication date: 01 January 2022
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