Pennisi Flavia, D'Amelio Anna Carole, Cuciniello Rita, Borlini Stefania, Mirzaian Luigi, Ricciardi Giovanni Emanuele, Minerva Massimo, Gianfredi Vincenza, Signorelli Carlo
PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy.
School of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, Italy.
Vaccines (Basel). 2025 Jan 4;13(1):37. doi: 10.3390/vaccines13010037.
BACKGROUND/OBJECTIVES: Vaccines have been recognized as one of the most effective public health interventions. However, vaccine-associated anaphylaxis, although rare, is a serious adverse reaction. The incidence of anaphylaxis related to non-COVID-19 vaccines in adults remains underreported. This systematic review and meta-analysis aim to estimate the incidence of post-vaccination anaphylaxis across various vaccines in adults.
A comprehensive literature search of PubMed, Embase, Scopus, and Web of Science identified studies on anaphylaxis following vaccination in adults (≥18 years), excluding COVID-19 vaccines. PRISMA 2020 guidelines were followed. The protocol was registered in PROSPERO in advance (ID CRD42024566928). Random-effects and fixed-effects models were used to pool data and estimate the logit proportion, with the logit-transformed proportion serving as the effect size, thereby allowing for the calculation of event rates.
A total of 37 studies were included in the systematic review, with 22 studies contributing to the meta-analysis, representing a combined population of 206,855,261 participants. Most studies focused on influenza vaccines ( = 15). Across all studies, 262 anaphylactic cases were reported, with 153 cases related to influenza vaccines, followed by herpes zoster virus vaccines (38 cases) and yellow fever vaccines (29 cases). Td/Tdap vaccine had the lowest rate (0.0001 per 100,000 participants). The overall random-effects model yielded a logit proportion of -10.45 (95% CI: -12.09 to -8.82, < 0.001), corresponding to an event rate of 2.91 events per 100,000 subjects (95% CI: 0.56 to 14.73). Sensitivity analysis showed a higher incidence for influenza, hepatitis vaccines, and in vulnerable populations.
Anaphylaxis following vaccination in adults is rare but varies by vaccine type. Strengthened monitoring and preparedness are essential, especially in non-medical settings, to ensure a rapid response to anaphylaxis and maintain public confidence in vaccination programs.
背景/目的：疫苗已被公认为最有效的公共卫生干预措施之一。然而，疫苗相关的过敏反应虽然罕见，但却是一种严重的不良反应。成人中与非新冠疫苗相关的过敏反应发生率仍未得到充分报告。本系统评价和荟萃分析旨在估计成人接种各类疫苗后过敏反应的发生率。
通过对PubMed、Embase、Scopus和Web of Science进行全面的文献检索，确定了关于成人（≥18岁）接种疫苗后过敏反应的研究，不包括新冠疫苗。遵循PRISMA 2020指南。该方案已提前在PROSPERO注册（ID CRD42024566928）。采用随机效应模型和固定效应模型汇总数据并估计对数优势比，以对数转换后的比例作为效应量，从而计算事件发生率。
系统评价共纳入37项研究，其中22项研究纳入荟萃分析，涉及的参与者总数为206,855,261人。大多数研究聚焦于流感疫苗（n = 15）。在所有研究中，共报告了262例过敏反应病例，其中153例与流感疫苗有关，其次是带状疱疹病毒疫苗（38例）和黄热病疫苗（29例）。Td/Tdap疫苗的发生率最低（每10万名参与者中0.0001例）。总体随机效应模型得出的对数优势比为-10.45（95%CI：-12.09至-8.82，P < 0.001），相当于每10万名受试者中有2.91例事件发生（95%CI：0.56至14.73）。敏感性分析显示，流感疫苗、肝炎疫苗以及易感人群中的过敏反应发生率较高。
成人接种疫苗后发生过敏反应虽属罕见，但因疫苗类型而异。加强监测和准备工作至关重要，尤其是在非医疗环境中，以确保对过敏反应迅速做出反应，并维持公众对疫苗接种计划的信心。
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