Pfizer’s COVID-19 vaccine considered safe among children with chronic urticaria

Important points:

• Sixty-four percent of children with chronic urticaria reported no symptoms after the first dose of BNT162b2 COVID-19 vaccine.
• The most common symptom after both vaccinations was an injection site reaction.

The Pfizer-BioNTech BNT162b2 COVID-19 vaccine was not associated with the risk of adverse reactions in children with chronic urticaria. Journal of Allergy and Clinical Immunology: In Practice.

Also, COVID-19 infection in these children did not induce relapse of chronic urticaria. Catherine K. Zhu, MD, Written by the School of Medicine, McGill University, Montreal, and colleagues.

Atopy is considered a risk factor for post-vaccination hypersensitivity urticaria, etc.angioedema and anaphylaxis, the researchers said, leading to the hypothesis that children with chronic urticaria may be at increased risk for adverse reactions.

In this study, between December 2021 and March 2022, 101 children (50% boys, age (median age, 13 years) were recruited.

According to the researchers, 76 (75%) children had isolated chronic spontaneous urticaria (CSU), 14 (14%) had isolated chronic induced urticaria (CIndU), and 11 (11%) had both. at the same time.

After 74 (73%) of the cohort received the first dose 47 (64%) of BNT162b2 had no symptoms. In addition, 20 (27%) had injection site reactions (ISR) such as erythema, pain and swelling.

Six patients (8%) who received the first dose of vaccine had flu-like symptoms, including chills, fatigue, arthralgia, headache, mild fever and myalgia. One person (1%) had a high fever classified as ≥39°C.

Next, 56 (55%) children received a second dose of vaccine, 26 (46%) reported no symptoms, 18 (32%) reported ISR, 10 (18 %) reported flu-like symptoms, 1 (2%) reported high fever and 1 (2%) reported nausea.

Researchers also reported that 18 (17%) children were waiting for their second vaccination appointment at the time of the study.

No patient reported an allergic reaction, including exacerbation of CSU, and no patient reported chest discomfort or palpitations after the first or second dose of vaccine.

The researchers also said they found no statistically significant difference in the proportion of children who reported each type of side effect after the first and second doses of the vaccine.

The researchers examined 27 unvaccinated children (27%) and found that parental education (adjusted OR = 1.03; 95% CI, 0.83–1.28), gender (aOR = 0.93; 95% CI , 0.77-1.13) or 7-day urticaria activity scores (aOR = 0.99; 95% CI, 0.97-1).

Older children were more likely to be vaccinated (aOR = 1.05; 95% CI, 1.02-1.08). Children in the unvaccinated group were also more likely to take higher doses of second-generation antihistamines than the vaccinated group (P. < .01).

These high-dose second-generation antihistamines among unvaccinated children may also help children with more resistant chronic urticaria hesitate to get vaccinated for fear of urticaria flare-ups. suggests that it is likely that

Of the 17 patients (17%) who developed COVID-19, 9 (53%) were unimmunized at the time of infection. Of these, 10 (59%) experienced flu-like symptoms and 5 (29%) were asymptomatic.

One patient with CSU (age 14) experienced an eczema flare-up lasting 12 hours and improved after applying topical hydrocortisone.

With most side effects characterized as minor, the researchers concluded that the risk of children with chronic urticaria developing an allergic reaction to COVID-19 vaccination was minimal and that COVID-19 infection was chronic. concluded that it does not cause relapse of urticaria.

However, while these findings indicate that the BNT162b2 vaccine is safe for children with chronic urticaria, the researchers continued, the vaccine is currently approved for that age group, so it can be used from 6 months of age onwards. We recommend evaluating the safety of COVID-19 mRNA vaccines in children aged 5 years. likewise.