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Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022

The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried re...

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Autores principales: Klosko, Rachel C., Lynch, Sarah E., Cabral, Danielle L., Nagaraju, Kanneboyina, Johnston, Yvonne A., Steinberg, Joshua D., McCall, Kenneth L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962937/
https://www.ncbi.nlm.nih.gov/pubmed/36851154
http://dx.doi.org/10.3390/vaccines11020276
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author Klosko, Rachel C.
Lynch, Sarah E.
Cabral, Danielle L.
Nagaraju, Kanneboyina
Johnston, Yvonne A.
Steinberg, Joshua D.
McCall, Kenneth L.
author_facet Klosko, Rachel C.
Lynch, Sarah E.
Cabral, Danielle L.
Nagaraju, Kanneboyina
Johnston, Yvonne A.
Steinberg, Joshua D.
McCall, Kenneth L.
author_sort Klosko, Rachel C.
collection PubMed
description The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86–4.54) in a medical provider’s office, 0.85 (95% CI, 0.26–2.43) in a pharmacy and 1.01 (95% CI, 0.15–3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71–1.47) in a medical provider’s office, 1.06 (95% CI, 0.72–1.54) in a pharmacy, and 1.12 (95% CI, 0.61–1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency.
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spelling pubmed-99629372023-02-26 Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022 Klosko, Rachel C. Lynch, Sarah E. Cabral, Danielle L. Nagaraju, Kanneboyina Johnston, Yvonne A. Steinberg, Joshua D. McCall, Kenneth L. Vaccines (Basel) Article The serious nature of post-vaccination anaphylaxis requires healthcare professionals to be adequately trained to respond to these hypersensitivity emergencies. The aim of this study was to compare outcomes reported with cases of vaccine anaphylaxis stratified by administration setting. We queried reports in the Vaccine Adverse Event Reporting System (VAERS) database from 2017 to 2022 and identified cases involving anaphylaxis with an onset within one day of vaccine administration. The primary outcome was the combined prevalence of death or disability for each setting while the secondary outcome was the prevalence of hospitalization. Adjusted (age, sex, prior history of allergy, vaccine type) odds ratios (aOR) and associated 95% confidence intervals (CI) were calculated using logistic regression analysis. A total of 2041 cases of anaphylaxis comprised the primary study cohort with representation in the sample from all 50 US states and the District of Columbia. The mean age was 43.3 ± 17.5 years, and most cases involved women (79.9%). Cases of anaphylaxis were reported after receiving a coronavirus vaccine (85.2%), influenza vaccine (5.9%), tetanus vaccine (2.2%), zoster vaccine (1.6%), measles vaccine (0.7%), and other vaccine (4.5%). Outcomes associated with reports of vaccine anaphylaxis included 35 cases of death and disability and 219 hospitalizations. Compared with all other settings, the aOR of death and disability when anaphylaxis occurred was 1.92 (95% CI, 0.86–4.54) in a medical provider’s office, 0.85 (95% CI, 0.26–2.43) in a pharmacy and 1.01 (95% CI, 0.15–3.94) in a public health clinic. Compared with all other settings, the aOR of hospitalization when anaphylaxis occurred was 1.02 (95% CI, 0.71–1.47) in a medical provider’s office, 1.06 (95% CI, 0.72–1.54) in a pharmacy, and 1.12 (95% CI, 0.61–1.93) in a public health clinic. An analysis of a national database across six years revealed no significant differences in the odds of death/disability and odds of hospitalization associated with post-vaccination anaphylaxis in the medical office, pharmacy, and public health clinic compared with all other settings. This study expands our understanding of the safety of immunization services and reinforces that all settings must be prepared to respond to such an emergency. MDPI 2023-01-28 /pmc/articles/PMC9962937/ /pubmed/36851154 http://dx.doi.org/10.3390/vaccines11020276 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Klosko, Rachel C.
Lynch, Sarah E.
Cabral, Danielle L.
Nagaraju, Kanneboyina
Johnston, Yvonne A.
Steinberg, Joshua D.
McCall, Kenneth L.
Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022
title Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022
title_full Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022
title_fullStr Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022
title_full_unstemmed Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022
title_short Death and Disability Reported with Cases of Vaccine Anaphylaxis Stratified by Administration Setting: An Analysis of the Vaccine Adverse Event Reporting System from 2017 to 2022
title_sort death and disability reported with cases of vaccine anaphylaxis stratified by administration setting: an analysis of the vaccine adverse event reporting system from 2017 to 2022
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9962937/
https://www.ncbi.nlm.nih.gov/pubmed/36851154
http://dx.doi.org/10.3390/vaccines11020276
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