Is your Covid vaccine venue ready to handle rare life-threatening reactions?

As the rollout of the covid-19 vaccine spreads across the United States, moving from hospital distribution to pharmacies, pop-up sites, and drive-through clinics, health professionals say these expanded venues can be rare but life-threatening. He states that it is important to be prepared to deal with some of the things. Allergic reaction.

“We want to be able to treat anaphylaxis,” said Dr. Mitchell Grayson, an allergy immunologist at the National Children’s Hospital in Columbus, Ohio. “I hope the ambulance is in a location that can be reached within 5 to 10 minutes.”

Of the more than 6 million people in the United States who received injections of the two new covid vaccines, at least 29 suffer from anaphylaxis. This is a serious and dangerous reaction that can constrict the airways and shock the body. Centers for Disease Control and Prevention.

Such incidents were rare (about 5.5 cases for every 1 million doses of vaccine in the United States from mid-December to early January) and patients recovered. For most people, the risk of getting a coronavirus is much higher than the risk of a vaccine response and is not a reason to avoid firing, Grayson said.

Still, the rate of anaphylaxis so far is about five times higher with the covid vaccine. Influenza vaccination, And some of those victims had no history of allergic reactions. In this early stage of vaccination, all patients were treated in hospitals and health centers, and full-service emergency care was readily available.

Shots are managed by a variety of professionals, including drugstores, dental clinics, and temporary sites with National Guard participation, as the state is considering expanding distribution. Health officials say that all sites involved in expanding the wider community need to be aware of the problem and have training and equipment to respond quickly in the event of a problem.

Dr. Nancy Mesonier, director of the CDC’s National Center for Vaccination and Respiratory Medicine, said: By phone with the reporter. She mentioned a common epinephrine syringe that many people with severe allergies carry. Those healthcare professionals must also be aware of warning signs of the need for advanced care, she added.

Anaphylaxis usually occurs within minutes and can cause life-threatening problems such as hives, nausea, vomiting, dizziness and fainting, hypotension and airway narrowing. The initial treatment is an injection of epinephrine or adrenaline to reduce the body’s allergic reaction. However, critically ill patients may require intensive care such as oxygen, IV antihistamines, and steroids such as cortisone to save lives. Community sites are unlikely to have these treatments at hand and need immediate access to emergency personnel.

Anyone who administers a vaccine needs to not only make EpiPen available, but frankly, know how to use it.

Dr. Nancy Mesonier, CDC

Scientists are still investigating what is causing the serious response to the Pfizer-BioNTech and Modern RNA vaccines. They suspect that the cause may be polyethylene glycol, or an ingredient present in both vaccines associated with allergic reactions.

Despite seeking education and support from providers, experts 50 million Americans with allergies Actively find well-prepared places such as food, insect toxins, medicines and other vaccines. Dr. Kimberly Blumenthal, Head of Allergy Quality and Safety at Massachusetts General Hospital, said he would contact the scene and ask the questions pointed out about emergency precautions before vaccination.

“Ask me: Do they have an anaphylaxis kit? Can they take vital signs?” She said. She added that people who carry EpiPen on a daily basis should remember to bring it with them when they are vaccinated.

CDC website It details the list of devices and medications the site should have and encourages all patients to observe for 15 minutes after vaccination, or 30 minutes if they are at high risk of reaction. This list recommends, but does not require, stocking more intensive treatments such as IVs on the site. Authorities said people experiencing severe reactions should not receive the recommended second dose of the vaccine.

“If an acute anaphylactic reaction occurs after administration of the mRNA COVID-19 vaccine, appropriate treatment for severe allergic reactions must be readily available,” the site said.

Still, given the scope of vaccination efforts, it’s a difficult order. The federal government has sent vaccines to more than 40,000 pharmacy locations, including 19 chains including CVS, Walgreens, Costco and Rite Aid. At the same time, New York City has an increasing number of dozens of pop-up inoculation sites, with drive-through clinics in Ohio, Florida, and other states.

Drive-through sites in particular are worried about allergists like Blumenthol, who said it was important to quickly recognize the symptoms of anaphylaxis. “If you’re in a car, can you open the window? Where are the medicines? Are you in the parking lot?” She said. “It just sounds more logistically more challenging.”

Ask the question: Do they have an anaphylaxis kit? Can they take vital signs?

Dr. Kimberly Blumenthal, Massachusetts General Hospital

By January 6, more than 2,400 people had been vaccinated in Columbus. Drive-through clinic Installed at Ohio Expo Center. No allergic reactions have been reported, according to Kelli Newman, a spokesman for Columbus Public Health. But if they happen, health officials are ready, she said.

“We are affiliated with EMS and have observed that EMS has been vaccinated for 15 minutes to ensure that there are no side effects,” Newman said in an email. “They have access to two EMS trucks, equipped with emergency equipment and epinephrine, if needed.”

Similarly, representatives of CVS Health and Walgreens said they have staff and equipment to handle “rare but serious” reactions.

“We have an emergency management protocol that all vaccine providers need, including administration of epinephrine, calling 911, and managing CPR as needed after clinical evaluation. “There is,” said Walgreens spokeswoman Rebekah Pajak in an email. ..

Dr. David Lang, a former president of the American Academy of Allergology, said that with the right trained staff and the right equipment and facilities at the vaccination site, the majority of people, especially because of the ever-increasing pandemics. He said he should choose an injection. President of the Department of Immunology, Asthma and Immunology and Cleveland Clinic.

“The overwhelming potential is that there is no anaphylaxis and the overwhelming benefits far outweigh the risks of harm,” Lang said.