Immunology Unit, University Hospital, Verona, Italy.
Curr Opin Allergy Clin Immunol. 2021 Oct 1;21(5):418-425. doi: 10.1097/ACI.0000000000000769.
This review aims to provide an updated report in regards to the correlation between vaccines and anaphylaxis and the related risk in the population.
Initial reports showed higher incidence of anaphylaxis following messenger RNA COVID-19 vaccines compared with 'routine' vaccinations, likely influenced by the great attention paid to these 'new' vaccines. However, anaphylaxis has still to be considered quite rare and its incidence will be systematically reconsidered in the light of additional data collected.
Adverse reactions to vaccines are commonly reported but most of them are nonspecific mild events, whereas vaccine-related anaphylaxis is considered a rare event, with an incidence rate equal to 1.3 cases per million vaccine doses administered. As anaphylaxis reports usually start to be reported to passive pharmacovigilance during postmarketing surveillance, the first data are used to be influenced by under- and over-reporting and lack of denominators and following studies are needed to confirm the causal relationship. This might create an initial overcautiously approach to new immunization practices but, being anaphylaxis a potential life-threatening event, every suspected contraindication has to be deepened to maximize effectiveness and safety profile and constantly redefined not to exclude an overestimated population group who could receive the vaccine uneventfully.
本综述旨在提供疫苗与过敏反应相关性及其在人群中相关风险的最新报告。
最初的报告显示，信使 RNA COVID-19 疫苗接种后过敏反应的发生率高于“常规”疫苗接种，这可能受到对这些“新”疫苗的高度关注的影响。然而，过敏反应仍然被认为相当罕见，其发生率将根据收集到的额外数据进行系统重新考虑。
疫苗不良反应通常有报道，但大多数是非特异性轻度事件，而疫苗相关过敏反应被认为是罕见事件，发生率等于每接种百万剂疫苗 1.3 例。由于过敏反应报告通常在上市后监测期间开始通过被动药物警戒报告，最初的数据受到报告不足和过度报告、缺乏分母的影响，因此需要进一步研究来确认因果关系。这可能导致对新免疫接种实践的初步过度谨慎，但过敏反应是一种潜在的危及生命的事件，因此必须深入研究每一个可疑的禁忌症，以最大限度地提高有效性和安全性，并不断重新定义，以避免排除可能安然接受疫苗的高估人群。
