Journal of Medical Society

LETTER TO EDITOR
Year
: 2021  |  Volume : 35  |  Issue : 1  |  Page : 46-

Safety of COVID-19 vaccine in the patient with history of drug allergy: An issue to be monitored


Pathum Sookaromdee1, Viroj Wiwanitkit2,  
1 Private Academic Consultant, Bangkok, Thailand
2 Department of Community Medicine, Dr DY Patil University, Pune, Maharashtra, India

Correspondence Address:
Pathum Sookaromdee
Private Academic Consultant, Bangkok
Thailand




How to cite this article:
Sookaromdee P, Wiwanitkit V. Safety of COVID-19 vaccine in the patient with history of drug allergy: An issue to be monitored.J Med Soc 2021;35:46-46


How to cite this URL:
Sookaromdee P, Wiwanitkit V. Safety of COVID-19 vaccine in the patient with history of drug allergy: An issue to be monitored. J Med Soc [serial online] 2021 [cited 2022 May 19 ];35:46-46
Available from: https://www.jmedsoc.org/text.asp?2021/35/1/46/323163


Full Text



Sir,

COVID-19 vaccine is the newest vaccine for COVID-19 containment. At present, more than one million doses of vaccines have already been administered in many countries. There are already some reports on the postvaccination adverse effects of the new vaccines. Many reports are from the US and Europe.[1],[2] In a recent publication in British Medical Journal (BMJ),[3] it is recommended that the allergy test might be applied for risk assessment among people who report allergies. However, there is still a simple question that we should better not vaccinate anyone who reports a history of allergy or not.

Here, we would like to share the latest public data from the first public report (March 2021) on COVID-19 vaccination in Indochina. In this setting, a non-mRNA vaccine, inactivated vaccine, is used and the preliminary report by local CDC (https://covid-19.kapook.com/view238376.html and https://gnews.apps.go.th/news?news=79505) noted that there were 7,262 vaccinnees within the first 3 – day period and the severe adverse effect was already reported in 1 case, giving incidence rate equal to 0.0138 % or 138 per 1,000,000. The indexed case who developed severe adverse effect had a history of penicillin allergy but still received COVID-19 vaccine. Although some scientists might propose that non-mRNA COVID-19 vaccine is safer than RNA COVID-19 vaccine, the data from the preliminary report are discordant. Comparing the data to the previous report on mRNA COVID-19 vaccine (anaphylaxis rate: 11.1/1,000,000[1]), the observed severe adverse effect is significantly higher. It might assume that any person with history of any allergy (drug, food, or others) should not be vaccinated, regardless of type of vaccine, until there are more evidences to confirm for safety. The basic principle of “first do no harm” should be applied for decision-making in vaccination for a case with history of allergy.[4]

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1CDC COVID-19 Response Team, Food and Drug Administration. Allergic reactions including anaphylaxis after receipt of the first dose of Pfizer-BioNTech COVID-19 Vaccine-United States, December 14-23, 2020. MMWR Morb Mortal Wkly Rep 2021;70:46-51.
2Banerji A, Wickner PG, Saff R, Stone CA Jr., Robinson LB, Long AA, et al. mRNA vaccines to prevent COVID-19 disease and reported allergic reactions: Current evidence and suggested approach. J Allergy Clin Immunol Pract 2021;9:1423-37.
3Glover RE, Urquhart R, Lukawska J, Blumenthal KG. Vaccinating against covid-19 in people who report allergies. BMJ 2021;372:n120.
4Wiwanitkit V. Re: Vaccinating Against Covid-19 in People Who Report Allergies. Available from: https://www.bmj.com/content/372/bmj.n120/rr-2. [Last accessed on 2021 Jul 10].