COVID-19 VACCINE-ASSOCIATED ANAPHYLAXIS: A STATEMENT OF THE WORLD ALLERGY ORGANIZATION ANAPHYLAXIS COMMITTEE

TURNER, Paul J.; ANSOTEGUI, Ignacio J.; CAMPBELL, Dianne E.; CARDONA, Victoria; EBISAWA, Motohiro; EL-GAMAL, Yehia; FINEMAN, Stanley; GELLER, Mario; GONZALEZ-ESTRADA, Alexei; GREENBERGER, Paul A.; LEUNG, Agnes S.Y.; LEVIN, Michael E.; MURARO, Antonella; SÁNCHEZ BORGES, Mario; SENNA, Gianenrico; TANNO, Luciana K.; Yu-Hor THONG, Bernard; WORM, Margitta

Vaccines against COVID-19 (and its emerging variants) are an essential global intervention to control the current pandemic situation. Vaccines often cause adverse events; however, the vast majority of adverse events following immunization (AEFI) are a consequence of the vaccine stimulating a protective immune response, and not allergic in etiology. Anaphylaxis as an AEFI is uncommon, occurring at a rate of less than 1 per million doses for most vaccines. However, within the first days of initiating mass vaccination with the Pfizer-BioNTech COVID-19 vaccine BNT162b2, there were reports of anaphylaxis from the UK and USA. More recent data implies an incidence of anaphylaxis closer to 1:125,000 doses with respect to the Pfizer-BioNTech vaccine. In this position paper, we discuss the background to reactions to the current COVID-19 vaccines and relevant steps to mitigate against the risk of anaphylaxis as an AEFI. We propose a global surveillance strategy led by allergists in order to understand the potential risk and generate data to inform evidence-based guidance, and thus provide reassurance to public health bodies and members of the public.