Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Background: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy. Objective: We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination. Methods: COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged >18 years and vaccinated with >1 dose of any COVID-19 vaccine. We evaluated CU exacerbations and severe allergic reactions as well as other adverse events associated with COVID-19 vaccinations and their association with various CU parameters. Results: Across 2769 COVID-19–vaccinated CU patients, most (90%) received at least 2 COVID-19 vaccine doses, and most patients received CU treatment and had well-controlled disease. The rate of COVID-19 vaccination–induced CU exacerbation was 9%. Of 223 patients with CU exacerbation after the first dose, 53.4% experienced recurrence of CU exacerbation after the second dose. CU exacerbation most often started <48 hours after vaccination (59.2%), lasted for a few weeks or less (70%), and was treated mainly with antihistamines (70.3%). Factors that increased the risk for COVID-19 vaccination–induced CU exacerbation included female sex, disease duration shorter than 24 months, having chronic spontaneous versus inducible urticaria, receipt of adenovirus viral vector vaccine, having nonsteroidal anti-inflammatory drug/aspirin intolerance, and having concerns about getting vaccinated; receiving omalizumab treatment and Latino/Hispanic ethnicity lowered the risk. First-dose vaccine–related adverse effects, most commonly local reactions, fever, fatigue, and muscle pain, were reported by 43.5% of CU patients. Seven patients reported severe allergic reactions. Conclusions: COVID-19 vaccination leads to disease exacerbation in only a small number of CU patients and is generally well tolerated. (J Allergy Clin Immunol 2023;152:1095-106.)

• Autores: Sánchez Caraballo, Jorge Marío; Giménez Arnau, Ana María; Kocaturk, Emek; Vera Ayala, Carolina E.; Criado, Paulo Ricardo
• Tipo de recurso: Article of investigation
• Fecha de publicación: 2023
• Institución: Universidad de Antioquia
• Repositorio: Repositorio UdeA
• Idioma: eng
• OAI Identifier: oai:bibliotecadigital.udea.edu.co:10495/46816
• Acceso en línea: https://hdl.handle.net/10495/46816
• Palabra clave: Vacunas contra la COVID-19 - efectos adversos; COVID-19 Vaccines - adverse effects; COVID-19 - prevención y control; COVID-19 - prevention and control; Urticaria Crónica; Chronic Urticaria; Estudios Retrospectivos; Retrospective Studies; Urticaria - tratamiento farmacológico; Urticaria - drug therapy; Vacunación - efectos adversos; Vaccination - adverse effects; Brote de los Síntomas; Symptom Flare Up; Omalizumab; https://id.nlm.nih.gov/mesh/D000086663; https://id.nlm.nih.gov/mesh/D000086382; https://id.nlm.nih.gov/mesh/D000080223; https://id.nlm.nih.gov/mesh/D012189; https://id.nlm.nih.gov/mesh/D014581; https://id.nlm.nih.gov/mesh/D014611; https://id.nlm.nih.gov/mesh/D000067251; https://id.nlm.nih.gov/mesh/D000069444; ODS 3: Salud y bienestar. Garantizar una vida sana y promover el bienestar de todos a todas las edades
• Rights: openAccess
• License: http://creativecommons.org/licenses/by-nc-nd/4.0/