Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines

Background: Adverse effects following immunizations (AEFIs) can contribute to vaccine hesitancy. Objective: We evaluated clinical outcomes of AEFIs subsequent to administration of the coronavirus disease 2019 (COVID-19) vaccine at 2 pediatric allergy centers. Methods: Data on pediatric patients refe...

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Main Authors: Qin Ying Lim, MBBS, Tsun Ming Lau, BSc, Sophie H.Y. Lai, MBBS, Gilbert T. Chua, MBBS, Kaiyue Zhang, MPH, Jennifer H.Y. Lam, BSc (Hon), Wilfred H.S. Wong, PhD, Yu Lung Lau, MD (Hon), Jaime S. Rosa Duque, MD
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Journal of Allergy and Clinical Immunology: Global
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Online Access:http://www.sciencedirect.com/science/article/pii/S2772829324001838
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author Qin Ying Lim, MBBS
Tsun Ming Lau, BSc
Sophie H.Y. Lai, MBBS
Gilbert T. Chua, MBBS
Kaiyue Zhang, MPH
Jennifer H.Y. Lam, BSc (Hon)
Wilfred H.S. Wong, PhD
Yu Lung Lau, MD (Hon)
Jaime S. Rosa Duque, MD
author_facet Qin Ying Lim, MBBS
Tsun Ming Lau, BSc
Sophie H.Y. Lai, MBBS
Gilbert T. Chua, MBBS
Kaiyue Zhang, MPH
Jennifer H.Y. Lam, BSc (Hon)
Wilfred H.S. Wong, PhD
Yu Lung Lau, MD (Hon)
Jaime S. Rosa Duque, MD
author_sort Qin Ying Lim, MBBS
collection DOAJ
description Background: Adverse effects following immunizations (AEFIs) can contribute to vaccine hesitancy. Objective: We evaluated clinical outcomes of AEFIs subsequent to administration of the coronavirus disease 2019 (COVID-19) vaccine at 2 pediatric allergy centers. Methods: Data on pediatric patients referred for COVID-19 AEFI concerns between March 2021 and October 2022 were reviewed. The collected data included patient demographics, clinical characteristics, outcomes of prior COVID-19 vaccination, recommendations after consultation, and outcomes of revaccination. Results: The 163 patients were separated into 2 groups based on the absence (n = 89 [54.6%]) or presence (n = 74 [45.4%]) of prior COVID-19–related AEFIs. The most common reason for referral without a prior AEFI was another suspected drug allergy (n = 58 [35.6%]). All patients in this group were recommended for COVID-19 vaccination. Of the 163 patients, 82 (92.1%) proceeded with vaccination, with 77 of them (93.9%) tolerating vaccination. Most of those with a prior COVID-19–related AEFI had a delayed cutaneous reaction (n = 60 [37.0%]); 1 patient (0.6%) had suspected anaphylaxis. In this group, 6 (8.1%) were advised to postpone COVID-19 vaccination until their debilitating skin conditions had improved in response to further treatment, whereas 45 (77.6%) tolerated subsequent vaccination to the same or an alternate COVID-19 vaccine type. The most common AEFI on revaccination was urticaria (in 8 of 11 patients [72.7%]). AEFI on revaccination was significantly associated with a history of spontaneous urticaria or angioedema (relative risk = 3.6 [95% CI = 1.30-9.99]; P = .020) and urticaria following COVID-19 vaccination previously (relative risk = 4.12 [95% CI = 1.22-13.87]; P = .017). Conclusions: Children with a history of urticaria or angioedema related or unrelated to prior COVID-19 vaccination were at higher risk of a COVID-19–related AEFI on revaccination, although most were able to complete the vaccination series under the management of our immunology/allergy service.
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spelling doaj-art-58df53e74cbf4e4da736de445a0842512025-08-20T02:40:10ZengElsevierJournal of Allergy and Clinical Immunology: Global2772-82932025-02-014110038710.1016/j.jacig.2024.100387Outcomes of pediatric patients with suspected allergies to COVID-19 vaccinesQin Ying Lim, MBBS0Tsun Ming Lau, BSc1Sophie H.Y. Lai, MBBS2Gilbert T. Chua, MBBS3Kaiyue Zhang, MPH4Jennifer H.Y. Lam, BSc (Hon)5Wilfred H.S. Wong, PhD6Yu Lung Lau, MD (Hon)7Jaime S. Rosa Duque, MD8Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China; Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China; Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China; Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China; Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, ChinaDepartment of Paediatrics and Adolescent Medicine, Queen Mary Hospital, Hong Kong Special Administrative Region, Hong Kong, China; Department of Paediatrics and Adolescent Medicine, University of Hong Kong, Hong Kong, China; Department of Paediatrics and Adolescent Medicine, Hong Kong Children’s Hospital, Hong Kong, China; Corresponding author: Jaime S. Rosa Duque, MD, PhD, DCH (UK), FAAP, FHKAM (Paediatrics), FHKCPaed, FACAAI, FAAAAI, Room 115, New Clinical Building, Queen Mary Hospital, 102 Pokfulam Road, Hong Kong Special Administrative Region, China.Background: Adverse effects following immunizations (AEFIs) can contribute to vaccine hesitancy. Objective: We evaluated clinical outcomes of AEFIs subsequent to administration of the coronavirus disease 2019 (COVID-19) vaccine at 2 pediatric allergy centers. Methods: Data on pediatric patients referred for COVID-19 AEFI concerns between March 2021 and October 2022 were reviewed. The collected data included patient demographics, clinical characteristics, outcomes of prior COVID-19 vaccination, recommendations after consultation, and outcomes of revaccination. Results: The 163 patients were separated into 2 groups based on the absence (n = 89 [54.6%]) or presence (n = 74 [45.4%]) of prior COVID-19–related AEFIs. The most common reason for referral without a prior AEFI was another suspected drug allergy (n = 58 [35.6%]). All patients in this group were recommended for COVID-19 vaccination. Of the 163 patients, 82 (92.1%) proceeded with vaccination, with 77 of them (93.9%) tolerating vaccination. Most of those with a prior COVID-19–related AEFI had a delayed cutaneous reaction (n = 60 [37.0%]); 1 patient (0.6%) had suspected anaphylaxis. In this group, 6 (8.1%) were advised to postpone COVID-19 vaccination until their debilitating skin conditions had improved in response to further treatment, whereas 45 (77.6%) tolerated subsequent vaccination to the same or an alternate COVID-19 vaccine type. The most common AEFI on revaccination was urticaria (in 8 of 11 patients [72.7%]). AEFI on revaccination was significantly associated with a history of spontaneous urticaria or angioedema (relative risk = 3.6 [95% CI = 1.30-9.99]; P = .020) and urticaria following COVID-19 vaccination previously (relative risk = 4.12 [95% CI = 1.22-13.87]; P = .017). Conclusions: Children with a history of urticaria or angioedema related or unrelated to prior COVID-19 vaccination were at higher risk of a COVID-19–related AEFI on revaccination, although most were able to complete the vaccination series under the management of our immunology/allergy service.http://www.sciencedirect.com/science/article/pii/S2772829324001838AllergyCOVID-19drugpediatricvaccine
spellingShingle Qin Ying Lim, MBBS
Tsun Ming Lau, BSc
Sophie H.Y. Lai, MBBS
Gilbert T. Chua, MBBS
Kaiyue Zhang, MPH
Jennifer H.Y. Lam, BSc (Hon)
Wilfred H.S. Wong, PhD
Yu Lung Lau, MD (Hon)
Jaime S. Rosa Duque, MD
Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines
Journal of Allergy and Clinical Immunology: Global
Allergy
COVID-19
drug
pediatric
vaccine
title Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines
title_full Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines
title_fullStr Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines
title_full_unstemmed Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines
title_short Outcomes of pediatric patients with suspected allergies to COVID-19 vaccines
title_sort outcomes of pediatric patients with suspected allergies to covid 19 vaccines
topic Allergy
COVID-19
drug
pediatric
vaccine
url http://www.sciencedirect.com/science/article/pii/S2772829324001838
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