Table 2.
Patient Characteristics, Skin Test Results, and Outcomes of Second Dose Given by Graded Administration for Patients With Reaction to First mRNA COVID-19 Vaccine Dose (n=15)
| Age, y
Sex |
Atopic History | Vaccine Manufacturer | Symptoms After First Dose | Time to Symptom Onset, min | Treatment After First Dose | ED Evaluation | Skin Test Performed | Positive Skin Test Component | Reaction to Second Dose Via Graded Administration (Step Number) | Treatment With Graded Administration (Step Number) | Serum S IgG Titer, Log2 Dilution |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 40
F |
Asthma | Pfizer-BioNTech | Dyspnea, lightheadedness | 10 | Albuterol | No | No | N/A | Cough (1, 4), throat tightness (4) | Cetirizine (1), albuterol (1, 4), epinephrine (4) | 15.85 |
| 32
F |
FA, AR, asthma, venom allergy | Moderna | Urticaria, nausea | 15 | Diphenhydramine | No | Yes | Vaccine (ID) | Nausea (3, 5), urticaria (5) | Cetirizine (3, 5), epinephrine (5) | 16.85 |
| 28
F |
None | Moderna | Angioedema, nonurticarial rash | 15 | Diphenhydramine | Yes | Yes | None | Throat tightness (3) | Cetirizine (3) | 19.35 |
| 39
F |
AR | Moderna | Urticaria, | 15 | Famotidine, methylprednisolone | Yes | Yes | Vaccine (ID) | None | None | 17.85 |
| 64
F |
FA | Moderna | Urticaria | 10 | Diphenhydramine | No | Yes | Vaccine (ID) | Pruritus (1, 5) | None | 16.35 |
| 60
F |
AR | Pfizer-BioNTech | Urticaria | 10 | Diphenhydramine | No | No | N/A | Pruritus (4), rhinorrhea (4) | Cetirizine (4) | 15.85 |
| 37
F |
Asthma AR | Moderna | Nonurticarial rash, dyspnea | 10 | Diphenhydramine, dexamethasone | Yes | Yes | PEG (ID), polysorbate (ID) | None | None | -b |
| 47
F |
AR | Pfizer-BioNTech | Angioedema | 30 | None | No | Yes | Nonea | None | None | 16.85 |
| 44
F |
None | Pfizer-BioNTech | Nonurticarial rash, | 30 | Diphenhydramine | Yes | No | N/A | None | None | 17.85 |
| 49
F |
AR, FA | Pfizer-BioNTech | Nonurticarial rash, angioedema | 10 | Diphenhydramine | No | Yes | PEG (ID), polysorbate (ID), vaccine (ID) | None | None | 16.85 |
| 63
F |
None | Pfizer-BioNTech | Urticaria | 40 | None | No | Yes | None | None | None | 17.35 |
| 41
F |
AR | Moderna | Lightheadedness, urticaria | 10 | None | No | No | N/A | None | None | 18.85 |
| 39
F |
Asthma, FA | Moderna | Urticaria | 45 | Cetirizine | No | Yes | PEG (ID), polysorbate (ID) | None | None | -b |
| 39
F |
AR | Moderna | Nausea/vomiting lightheadedness | 30 | None | No | Yes | None | None | None | 17.85 |
| 21
F |
Asthma, AR | Pfizer-BioNTech | Angioedema, dyspnea, nausea, lightheadedness | 20 | Epinephrine | Yes | Yes | None | Dyspnea, pruritus (1) | Albuterol (1), cetirizine (1) | 17.85 |
Abbreviations: AR, allergic rhinitis; COVID-19, coronavirus disease 2019; ED, emergency department; FA, food allergy; ID, intradermal; mRNA, messenger RNA; PEG, polyethylene glycol.
Skin test positive to vaccine 24 hours later.
Results not available.