Vaccination against SARS-CoV-2 of adult allergic patients – experience from the Clinical Hospital Center Rijeka

Autori:

Dora Palčevski, Sandra Peternel , Katarina Dujmović-Hasanbegović, Martina Pavletić, Srđan Novak

Sažetak

Uvod: Uz korištenje preventivnih mjera (nošenje maski, higijena ruku, izolacija), masovno cijepljenje pučanstva ostaje najučinkovitiji način u borbi protiv pandemije COVID-19. Jedna od ozbiljnih reakcija preosjetljivosti na cjepivo jest anafilaksija. Cilj ovoga rada bio je prikazati iskustva Kliničkoga bolničkog centra (KBC) Rijeka u probiru i cijepljenju bolesnika u kojih postoji povećan rizik za razvoj anafilaksije ili srodne teške alergijske reakcije na cjepivo protiv SARS-CoV 2. Ispitanici i metode: U istraživanje su uključeni podatci o svim bolesnicima koji su registrirani u ambulanti za e savjetovanje KBC-a Rijeka tijekom 2021. godine, kojima je postavljena indikacija za cijepljenje u bolničkim uvjetima te koji su tijekom iste godine primili barem jednu dozu cjepiva protiv COVID-19. Upit o potrebi cijepljenja u bolničkim uvjetima postavljao je liječnik obiteljske medicine, a indikaciju je postavljao tim bolničkih liječnika alergologa. Pri cijepljenju je isključivo primjenjivano Pfizer (Comirnaty®) cjepivo. Rezultati: Od bolesnika kojima je kroz e-savjetovanje postavljena indikacija za cijepljenje u bolničkim uvjetima, tijekom 2021. godine cijepljeno je ukupno 451. Pritom je samo prvu dozu cjepiva primilo 138, obje doze 308, a docjepnu dozu pet bolesnika. Najčešća indikacija za cijepljenje putem dnevne bolnice bila je anamneza anafilaksije ili anafilaktoidne reakcije i to u 330 bolesnika (73,2%). Ukupno 97 bolesnika (21,5%) upućeno je zbog anamneze
neanafilaktičke alergijske reakcije, njih 17 (3,8%) zbog anamneze angioedema, a sedam bolesnika (1,6%) zbog ostalih razloga. Među bolesnicima cijepljenim putem dnevne bolnice niti jedan nije razvio anafilaktičku reakciju na cjepivo protiv SARS-CoV-2. Zabilježeno je ukupno šest blažih reakcija prilikom aplikacije cjepiva. Zaključak: U kontekstu morbiditeta i mortaliteta od COVID-19, korist cijepljenja daleko nadmašuje rizik od pojave anafilaksije, koja je liječiva. Ipak, potreban je nadzor pri cijepljenju osoba koje u anamnezi imaju anafilaksiju ili alergiju na neku od komponenti primjenjivanog cjepiva.

Summary

Introduction: In addition to preventive measures (wearing masks, hand hygiene, isolation), mass vaccination of the population remains the most effective means of combatting the COVID -19 pandemic. One of the serious hypersensitivity reactions to the vaccine is anaphylaxis. The aim of this study was to present the experience of the Clinical Hospital Center (CHC) Rijeka with screening and vaccination of patients at increased risk for anaphylaxis or similar severe allergic reaction to the SARS-CoV-2 vaccine. Participants and Methods: The study included data from all patients registered in the electronic consultation system of CHC Rijeka in 2021, in whom
vaccination in hospital setting was indicated and who had received at least one dose of the vaccine against COVID -19 in the same year. The inquiry about the need for vaccination at the day hospital was made by a general practitioner, and the indication was made by a team of hospital allergologists. Only Pfizer’s vaccine (Comirnaty®) was used for vaccination. Results: In 2021, a total of 451 patients were vaccinated based on the prior e-consultation. Of these, 138 received only the first dose of the vaccine, 308 received both doses, and five patients received three doses. The most common indication for in-hospital vaccination was a history of anaphylaxis or anaphylactoid reaction, in 330 (73.2%) patients. A total of 97 patients (21.5%) were referred for a history of non-anaphylactic allergic reaction, 17 (3.8%) for angioedema, and seven patients (1.6%) for other reasons. None of the patients vaccinated at the day hospital developed an anaphylactic reaction to the SARS-CoV-2 vaccine. A total of six patients reported mild reactions after vaccine administration. Conclusion: In the context of COVID -19 morbidity and mortality, the benefit of vaccination far outweighs the risk of anaphylaxis, which is readily treatable in the hospital setting. However, caution and prolonged monitoring is still warranted when vaccinating individuals with a history of anaphylaxis or allergy to any of the components of the administered vaccine.

Volumen: 9-10, 2022

Liječ Vjesn 2022;144:314–318

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