TABLE 1. Characteristics of reported cases of anaphylaxis (n = 21) after receipt of Pfizer-BioNTech COVID-19 vaccine — Vaccine Adverse Events Reporting System (VAERS), United States, December 14–23, 2020.
| Age (yrs) | Sex | Past history |
Onset after receipt (mins) | Signs and symptoms | Treatment setting† | Epi received | Brighton level§ | Outcome or disposition¶ | |
|---|---|---|---|---|---|---|---|---|---|
| Allergies or allergic reactions* | Anaphylaxis | ||||||||
| 27 |
F |
Tropical fruit |
No |
2 |
Diffuse erythematous rash, sensation of throat closure |
ED |
Yes |
2 |
Recovered at time of report |
| 35 |
M |
No |
No |
5 |
Diffuse erythematous rash, swollen tongue |
ED |
Yes |
1 |
Discharged home |
| 55 |
F |
Rabies vaccine |
Yes, rabies vaccine |
5 |
Generalized urticaria, wheezing |
Inpatient |
Yes |
1 |
Discharged home |
| 52 |
F |
Sulfa drugs |
Yes, sulfa drugs |
7 |
Wheezing, stridor, nausea |
Inpatient |
Yes |
1 |
Discharged home |
| 30 |
F |
Bee sting |
No |
8 |
Generalized urticaria, wheezing |
Inpatient |
Yes |
1 |
Recovered at time of report |
| 32 |
F |
No |
No |
10 |
Diffuse erythematous rash, difficulty breathing |
Inpatient |
Yes |
2 |
Discharged home |
| 60 |
F |
Eggs, milk, sulfa drugs, jellyfish sting |
Yes, jellyfish sting |
10 |
Diffuse erythematous rash, hoarseness |
ED |
Yes |
2 |
Recovered at time of report |
| 29 |
F |
Shellfish, eggs |
No |
10 |
Generalized urticaria, swollen lips and tongue |
ED |
Yes |
1 |
Discharged home |
| 52 |
F |
Metoprolol, clarithromycin |
No |
10 |
Generalized urticaria, stridor, wheezing |
ED |
Yes |
1 |
Recovered at time of report |
| 49 |
F |
Iodinated contrast media |
No |
13 |
Generalized urticaria, swollen throat |
ED |
Yes |
1 |
Recovered at time of report |
| 36 |
F |
No |
No |
13 |
Generalized urticaria, nausea |
ED |
Yes |
2 |
Not specified |
| 40 |
F |
Sulfa drugs, walnuts |
Yes, walnuts |
14 |
Generalized urticaria, nausea |
ED |
Yes |
2 |
Discharged home |
| 33 |
F |
Wasp sting |
No |
15 |
Diffuse erythematous rash, swollen lip |
ED |
Yes |
1 |
Recovered at time of report |
| 41 |
F |
Prochlorperazine |
Yes, prochlorperazine |
15 |
Diffuse erythematous rash, persistent dry cough |
ED |
No |
2 |
Discharged home |
| 57 |
F |
Penicillin, azithromycin |
Yes, unspecified |
15 |
Diffuse pruritic rash, hoarseness |
ED |
Yes |
2 |
Recovered at time of report |
| 45 |
M |
No |
No |
23 |
Generalized urticaria, swollen airway |
ED |
Yes |
2 |
Discharged home |
| 46 |
F |
Hydrocodone, nuts |
No |
25 |
Diffuse erythematous rash, difficulty swallowing |
ED |
Yes |
2 |
Discharged home |
| 30 |
F |
Cats, dogs |
No |
30 |
Generalized pruritis, wheezing |
ED |
No |
2 |
Discharged home |
| 44 |
F |
Influenza A(H1N1) vaccine |
Yes, influenza A(H1N1) vaccine |
34 |
Generalized urticaria, swollen lips |
ED |
Yes |
1 |
Discharged home |
| 29 |
F |
Sulfa drugs |
No |
54 |
Generalized urticaria, persistent cough |
ED |
Yes |
2 |
Recovered at time of report |
| 29 | F | Steroids | No | 150 | Diffuse pruritic rash, swollen lip | ED | Yes | 1 | Discharged home |
Abbreviations: COVID-19 = coronavirus disease 2019; ED = emergency department; epi = epinephrine; F = female; M = male.
* As documented in the VAERS report or medical records, or through confirmation with the treating health care provider or the patients themselves.
† Inpatient = inpatient hospitalization.
§ The Brighton Collaboration case definition uses combinations of symptoms to define levels of diagnostic certainty. Brighton Level 1 represents the highest level of diagnostic certainty that a reported case is indeed a case of anaphylaxis; Levels 2 and 3 are successively lower levels of diagnostic certainty. Level 4 is a case reported as anaphylaxis but that does not meet the Brighton Collaboration case definition. Level 5 is a case that was neither reported as anaphylaxis nor meets the case definition (https://doi.org/10.1016/j.vaccine.2007.02.064).
¶ As documented in the description of the adverse event in the VAERS report in Box 18 or as document in recovery status in Box 20.