Subacute Onset of Chronic Urticaria Post COVID-19 Vaccination

https://doi.org/10.1016/j.jaci.2022.12.782Get rights and content

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Rationale

Urticaria has been known to be triggered for a variety of allergy and non-allergic etiologies. Autoimmune disease, infection, and immunizations can be considered as possible underlying differentials for non-allergic urticarial eruption. I hypothesized that a subacute onset of chronic urticarial eruptions and/or demographic state was also possibly attributable to COVID-19 vaccinations in select patients observed at a single allergy and immunology practice.

Methods

Bassett Allergy and Immunology Clinic observed of patients referred for new onset urticaria evaluation between November 2021 and September 2022, 23 of the referred patients were identified as having COVID-19 immunization within the preceding 1-3 weeks. Patients often had accompanying new onset dermographia.

Results

Women accounted for 79% of the patients identified, the average age was 61.8 years old. Patient outcomes at 6 months of follow up were noted as resolution or control with interventions of 1st and/or 2nd generation H1 antihistamines, H2 antihistamines, leukotriene antagonists, systemic steroids, and/or omalizumab.

Conclusions

The immune activity promoted by COVID-19 vaccination, and vaccinations in general, may provoke a delayed onset non-IgE mediated demographic predominant urticaria state that appears to resolve within 6 months for the majority of patients affected.

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