Sumi Toshiyuki, Kodama Kentaro, Nishikiori Hirotaka, Tanaka Yusuke, Chiba Hirofumi
Respiratory Medicine, Hakodate Goryoukaku Hospital, Hakodate, JPN.
Respiratory Medicine and Allergology, Sapporo Medical University, Sapporo, JPN.
Cureus. 2023 Apr 25;15(4):e38122. doi: 10.7759/cureus.38122. eCollection 2023 Apr.
The widespread after-effects of the coronavirus disease 2019 (COVID-19) are still a grave threat worldwide. Among them are adverse reactions to vaccines, including those most observed following Pfizer-BioNTech (BNT162b2) vaccine administration, namely, local reactions at the injection site, fatigue, headache, myalgia, chills, arthralgia, and fever. Patients with asthma particularly present with unique adverse reactions to the BNT162b2 vaccine, notably, an exacerbation in their asthma symptoms as highlighted through the current case report. In this case, a 50-year-old woman had been undergoing treatment for bronchial asthma in the form of inhalation steroids and dupilumab, as well as systemic steroid prednisolone as maintenance therapy. She had mild injection site reactions after her first three COVID-19 vaccinations. She also experienced acute exacerbation requiring hospitalization after the fourth and fifth doses. Her symptoms resolved following steroid therapy. The close association between the timing of vaccinations and the onset of clinical symptoms suggests that the exacerbation episodes were triggered by the vaccine. Therefore, although the BNT162b2 vaccine is safe to administer in patients with bronchial asthma, cases reporting patients sensitized to the BNT162b2 vaccine developing bronchial asthma or experiencing asthma exacerbations should not be neglected. Clinicians should be aware of the possibility of flare-ups induced by repeated COVID-19 vaccinations in such patients.
2019冠状病毒病（COVID-19）的广泛后遗症在全球范围内仍然是一个严重威胁。其中包括对疫苗的不良反应，包括在接种辉瑞-生物科技公司（BNT162b2）疫苗后最常观察到的那些反应，即注射部位的局部反应、疲劳、头痛、肌痛、寒战、关节痛和发热。哮喘患者对BNT162b2疫苗尤其会出现独特的不良反应，特别是如本病例报告所强调的，其哮喘症状会加重。在该病例中，一名50岁女性一直在接受支气管哮喘治疗，采用吸入性类固醇和度普利尤单抗，以及全身性类固醇泼尼松龙作为维持治疗。她在前三次接种COVID-19疫苗后出现了轻微的注射部位反应。在接种第四剂和第五剂疫苗后，她还经历了需要住院治疗的急性加重。经类固醇治疗后，她的症状得到缓解。接种疫苗的时间与临床症状发作之间的密切关联表明，加重发作是由疫苗引发的。因此，尽管BNT162b2疫苗对支气管哮喘患者接种是安全的，但报告对BNT162b2疫苗敏感的患者发生支气管哮喘或哮喘加重的病例不应被忽视。临床医生应意识到此类患者反复接种COVID-19疫苗可能引发病情加重的可能性。
