Table II.
Characteristics and management of nonanaphylaxis allergic AEFI stratified by timing of onset (immediate vs delayed)
| Characteristic | All cases, (n = 107) | Immediate reaction (≤6 h; n = 24∗) | Delayed reaction (>6 h; n = 69∗) | Isolated urticaria and/or angioedema (n = 70) |
|---|---|---|---|---|
| Sex: female, n (%) | 91 (85) | 21 (88) | 57 (83) | 60 (86) |
| Age (y), median (IQR) | 38 (28-45) | 38 (29-52) | 37 (27-43) | 39 (28-46) |
| Time to reaction (h), median (IQR) | 24 (6-96) | 0.75 (0.1-3) | 48 (22-120) | 48 (11.5-120) |
| Allergy symptoms, n (%) | ||||
| Angioedema | 26 (24) | 6 (25) | 17 (25) | 16 (27) |
| Urticaria | 73 (68) | 12 (50) | 54 (78) | 61 (87) |
| Generalized pruritis | 30 (28) | 7 (29) | 22 (32) | 18 (26) |
| Respiratory symptoms† | 35 (33) | 12 (50) | 17 (25) | Excluded |
| Gastrointestinal symptoms† | 11 (10) | 3 (13) | 5 (7) | 3 (4) |
| Cardiovascular symptoms† | 7 (7) | 3 (13) | 2 (3) | Excluded |
| Patients with reactogenic effects‡ | 67 (63) | 14 (58) | 46 (67) | 41 (56) |
| Local injection-site reaction | 34 (32) | 8 (33) | 22 (32) | 19 (27) |
| Allergy history, n (%) | ||||
| None | 35 (33) | 7 (29) | 26 (38) | 30 (43) |
| Unknown | 19 (18) | 0 | 8 (12) | 15 (21) |
| Any atopic disease, n (%) | ||||
| Previous any anaphylaxis | 6 (6)§ | 3 (13) | 3 (4) | 3 (4) |
| Drug allergy | 11 (1) | 4 (17) | 7 (10) | 5 (7) |
| Asthma | 26 (24) | 9 (38) | 16 (23) | 8 (11) |
| Atopic dermatitis | 15 (14) | 2 (8) | 13 (12) | 8 (11) |
| Past medical history, n (%) | ||||
| Unknown | 17 (15) | 0 | 8 (12) | 14 (20) |
| None | 54 (50) | 10 (42) | 42 (60) | 32 (45) |
| HIV on ART | 3 (3) | 1 (4) | 2 (3) | 3 (4) |
| Patients with noncommunicable diseases | 24 (22)‖ | 14 (58) | 20 (29) | 24 (34) |
| COVID-19 before vaccination | 6 (6) | 4 (17) | 2 (2) | 4 (6) |
| Management, n (%) | ||||
| Unknown | 14 (13) | 0 (0) | 5 (7) | 13 (19) |
| Required treatment | 90 (84) | 24 (100) | 62 (90) | 57 (81) |
| Hospitalized: Admitted | 8 (8) | 3 (13) | 5 (7) | 1 (1) |
| Emergency room visit | 11 (10) | 4 (17) | 7 (10) | 4 (6) |
| Treatment(s) received, n (%) | ||||
| Adrenaline¶ | 5 (5) | 4 (17) | 1 (1) | 1 (1) |
| Systemic steroids | 30 (28) | 12 (50) | 18 (26) | 11 (16) |
| Antihistamines | 62 (58) | 18 (75) | 41 (59) | 44 (63) |
| Inhalational treatment# | 36 (33) | 9 (38) | 10 (14) | 0 |
| Other∗∗ | 16 (14) | 3 (13) | 13 (19) | 13 (19) |
ART, Antiretrovirals; HPT, hypertension; GORD, gastrooesphageal reflux disease; PCOS, polycystic ovary syndrome.
There were 14 participants in whom the time of reaction onset was unknown.
Respiratory symptoms included 1 or more of bronchospasm, upper airway swelling, subjective dyspnea without wheeze or stridor, persistent dry cough, hoarse voice, sensation of throat closure. Gastrointestinal symptoms included 1 or more of nausea and vomiting, diarrhea, abdominal pain. Cardiovascular symptoms included 1 or more of hypotension, tachycardia, and decreased level of consciousness or loss of consciousness.
Common nonallergic vaccine adverse events include 1 or more of fever (n = 49), headache (n = 53), or myalgia (n = 43).
Anaphylaxis to latex (n = 1), anaphylaxis to beta-lactam (n = 1), anaphylaxis to bee venom (n = 1), unknown (n = 3); however, no patients reported previous vaccine anaphylaxis.
Noncommunicable diseases include HPT (n = 11), diabetes (n = 5), dyslipidemia (n = 3), hypothyroidism (n = 5), GORD (n = 3), PCOS (n = 2), Gilberts disease (n = 1), congenital heart disease (n = 1), osteoporosis (n = 2), breast cancer in remission (n = 2), rheumatoid arthritis (n = 1), endometriosis (n = 1), and osteoarthritis (n = 1).
Received adrenaline due to severe bronchospasm or angioedema of the face and tongue.
Nebulization (n = 12), inhaled corticosteroids (n = 13), long-acting β-agonist/inhaled corticosteroid (n = 2), long-acting β-agonist (n = 2), short-acting β-agonist (n = 1).
Antibiotics (n = 3), paracetamol (n = 5), thiamine (n = 1), intravenous fluids (n = 6).