Anaphylaxis After Vaccination Reported To The Vaccine Adverse Event Reporting System, 1990–2016

Publication date: Available online 14 January 2019

Source: Journal of Allergy and Clinical Immunology

Author(s): John R. Su, Pedro L. Moro, Carmen Ng, Paige W. Lewis, Maria A. Said, Maria V. Cano

Abstract

Background

Anaphylaxis, a rare, potentially life-threatening hypersensitivity reaction, can occur after vaccination.

Objective

Describe reports of anaphylaxis after vaccination to the Vaccine Adverse Event Reporting System (VAERS) during 1990–2016.

Methods

We identified domestic reports of anaphylaxis within VAERS using a combination of Medical Dictionary for Regulatory Activity queries and Preferred Terms. We performed descriptive analysis, including history of hypersensitivity (e.g., anaphylaxis, respiratory allergies, drug allergies), and vaccines given. We reviewed all serious reports, and all non-serious reports with available medical records, to determine if they met the Brighton Collaboration case definition (BCCD) for anaphylaxis or were diagnosed by a physician.

Results

During the analytic period, VAERS received 467,960 total reports; 828 met BCCD for or were physician-diagnosed as anaphylaxis: 654 (79%) were classified as serious, and 669 (81%) had medical records available. Of 478 reports in children aged <19 years, 65% were male; childhood vaccines were most commonly reported. Of 350 reports in persons aged ≥19 years, 80% were female, and influenza vaccines were most frequently reported. Overall, 41% of reports described persons with no history of hypersensitivity. We identified 8 deaths, 4 among persons with no history of hypersensitivity.

Conclusion

Anaphylaxis after vaccination is rare in the United States, and can occur among persons with no history of hypersensitivity. Most persons recover fully with treatment, but serious complications, including death, can occur.

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