PRE-VACCINE COUNSELING TO ASSIST WITH RISK ASSESSMENT PRIOR TO COVID-19 VACCINATION

INTRODUCTION: During early vaccine roll-out of Pfizer-BioNTech, Moderna, and Johnson & Johnson (J&J) COVID-19 vaccines, reports of severe allergic reactions led to hesitancy among patients with allergic history and disorders. Evaluation was initially limited due to restricted access to vaccines and pandemic-associated clinical constraints. METHODS: We conducted a retrospective chart review of patients over 18 years of age who sought vaccine counseling in-person or by telehealth between December 1, 2020 and May 1, 2021 prior to their first dose of vaccine. Demographics, atopic history, anaphylaxis history and vaccine administration/reactions were recorded. Follow up phone calls were used to complete data collection. RESULTS: We identified 80 patients (N= 63 Female, 17 Male). The most frequently reported comorbidities included rhinitis (54%), asthma (36%), hypertension (21%), and chronic urticaria (21%). Twenty-six patients (33%) reported a history of anaphylaxis, 14 of which were attributed to medications. Of the 80 patients evaluated, 77 (93%) successfully completed a vaccination series (defined as 1 dose of J&J or 2 doses of an mRNA vaccine). Of the 77 patients that completed vaccination, 7 (9%) reported reaction to a dose of vaccine, all consistent with expected adverse effects. No reactions suggested anaphylaxis. Three patients elected not to receive vaccination; none of these patients had history of anaphylaxis. CONCLUSION: Many patients with atopic history expressed hesitancy regarding COVID-19 vaccine administration and sought pre-vaccine counseling. Our experience suggests an effective role for counseling in patients with no prior exposure to COVID-19 vaccination as over 90% of patients with allergic history, including anaphylaxis, were safely vaccinated.