Nashville, TN

Nashville community should be getting 2nd dose of mRNA COVID-19 vaccine despite allergic reaction from first dose

Lenny Schumacher

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NASHVILLE, TN — People around the world started to get their COVID-vaccine and some got an immediate allergic reaction to the first dose of an mRNA COVID-19-vaccine, manufactured by Moderna and Pfizer BioNTech, but that should not keep people to get their second dose of vaccine.

A study published in JAMA Internal Medicine on July 26 showed those individuals who had allergic reactions and continued to get their second dose of vaccine have tolerated those allergic reactions.

Most frequently reported allergic reactions include itching, flushing, or hives.

The research was led by allergists at Massachusetts General Hospital (MGH) with Matthew Krantz, MD, a second-year clinical fellow in Vanderbilt University Medical Center’s Allergy-Immunology Fellowship Program, and Jason Kwah, MD, MSCI, of Yale School of Medicine.

Before the mRNA vaccines were distributed publicly, Krantz has concerned about patients with underlying allergic histories. After people received their vaccine, as much as 2% got allergic reactions, followed by anaphylaxis, a life-threatening allergic reaction that has occurred in up to 2.5 per 10,000 people.

From the investigation research researchers were able to conclude that among 189 patients vaccinated, 32 (or 17% of those vaccinated) experienced anaphylaxis after their first dose of vaccine. The rest, 159 people (or 84%), continued to get their second dose. From the 159 who receive their second dose, including 19 with anaphylaxis, tolerate the second vaccine. About 32 people (about 20%) got potential mild allergic symptoms after the second dose and were treated with antihistamines.

The reaction to mRNA vaccines might be different from a classical allergy that is mediated by IgE, or immunoglobulin-E antibodies. In classical allergy, most cases occur due to the re-exposure of the same allergen that might cause similar or worse symptoms. Most of the allergen symptoms seem to be absent after they received a second dose of mRNA vaccines.

“The study provides reassurance that a first-dose potentially allergic reaction shouldn’t keep people from getting a second dose,” Krantz said.

The research was funded by the National Institutes of Health and MGH.

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