Krantz MS, Kwah JH, Stone CA, et al. - Researchers examined if individuals with a history of immediate and potentially allergic reactions to the first dose could be safely administered the second dose of Pfizer-BioNTech or Moderna vaccine.

• In this multicenter, retrospective study, participants were 189 patients with an immediate allergic reaction to the Pfizer-BioNTech or Moderna vaccine, which was defined as: (1) symptom onset within 4 hours of dose 1, (2) at least 1 allergic symptom, and (3) referral for an allergy/immunology consultation with in-clinic or telehealth assessment.

• The first-dose most frequently induced following reactions: flushing or erythema (53 [28%]), dizziness or lightheadedness (49 [26%]), tingling (46 [24%]), throat tightness (41 [22%]), hives (39 [21%]), and wheezing or shortness of breath (39 [21%]).

• Anaphylaxis criteria were met in 32 (17%) patients.

• A second dose was administered in a total of 159 patients (84%).

• The second dose was well tolerated by all 159 patients, including 19 individuals with first-dose anaphylaxis.

• Overall, Pfizer-BioNTech or Moderna vaccine second dose can be safely administered in patients who report immediate and potentially allergic reactions after the first dose.

• Although 20% of patients with second dose administration experienced mild symptoms, all patients who received a second dose safely completed their vaccination series and could use mRNA COVID-19 vaccines in the future when indicated.