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Kimberly Blumenthal, MD, MSc Profile picture
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13 Jan, 4 tweets, 8 min read
1/Brief #COVID19vaccine allergy update: LARGE LOCAL REACTIONS! These all were after #Moderna. Itchy, swollen, erythema, edema. Comes on late (>5 days) and can last weeks .Tx is symptomatic: antihistamine (e.g., fexofenadine), NSAID/Tylenol, ice. ImageImageImageImage
2/ Importantly, you CAN still get the second dose! In the #modernavaccine trial, delayed large locals like these occurred 4x less with 2nd dose than 1st dose. Fewer large locals AND more efficacy, sign me up!
@AllergyKidsDoc @DrAnneEllis @ericashenoy @EricMacyMD @ARLetourneau @MGHAllergy @mghaifellows @rebeccasaff @AnnaWolfsonMD @DrLeanaWen @EmilyHyle @karenrobbinsmd @PAallergy @darakass @AliRaja_MD @landmaad
We now have a better way for health professionals to submit allergy cases after #COVID19Vaccines ! @AleenaBanerjiMD @LaceyRobinsonMD @PaigeWickner @ATLergist @kristinkrasnow @KhouryMD @mgh_id @MGH_ClinEpi @AAAAI_org @ACAAI @JACIInPractice Image

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More from @KimberlyBlumen1

Kimberly Blumenthal, MD, MSc Profile picture
10 Jan
It has been a busy month learning about #allergy after #COVID19Vaccines but we so excited to receive this broad information from @CDCgov. Highlights below!/1
cdc.gov/mmwr/volumes/7…
*Potential #anaphylaxis 175 of 1,893,360 1st doses of @pfizer vaccines (0.009%; 90 per million)
*Confirmed #anaphylaxis, 21 of 1,893,360 1st doses of @pfizer vaccines (0.0011%; 11 per million)
-->Better than we thought (1 per 100,000)but greater than usual 1 per million)/2
*17 of 21 Anaphylaxis cases (81%) had allergy history; 7 of 21 (33%) had prior anaphylaxis
*Anaphylaxis occurred a median of 13 min (2–150 min) after vaccination; 71% occurred within 15 min (i.e., CDC recommended waiting/observation time)
*Follow-up for 20 patients & 100% OK /3
Read 5 tweets
Kimberly Blumenthal, MD, MSc Profile picture
21 Dec 20
1/Here is @CDCgov guidance for #allergy considerations about the @pfizer and @moderna_tx #COVID19vaccines : cdc.gov/vaccines/covid…
#AIMedEd #medtwitter #allergyandimmunologyrocks @ericashenoy
2/#allergy and #anaphylaxis can happen to any #drug or #vaccine, but reactions to #COVID19vaccine are exceedingly rare (~6 in >300K vaccinations so far--> 0.002%). #vaccines have always been a rare cause of allergic reactions in healthcare.
3/Recently we looked at ~3K allergic reactions in healthcare settings @MassGenBrigham: contrasts caused allergy the most & just 6 vaccine reactions in 10-years. @NeelamPhadkeMD @MGH_ClinEpi @lizhou08 @JieHealthAI @PaigeWickner
pubmed.ncbi.nlm.nih.gov/32959347/
Read 4 tweets
Kimberly Blumenthal, MD, MSc Profile picture
16 Dec 20
1/ OK so 1 week after UK #COVID19Vaccine allergy was described, I need to reorient you to my world, the world where #drugallergy is the best field of #MedTwitter #AIMedEd #allergyimmunologyrocks. Let's get down to this confusion about the #covid19vaccine and #allergy
2/ There is no reason to think that anyone -- other than patients with a known allergy to an ingredient in this vaccine or an ingredient cross-reactive to an ingredient in this vaccine -- might have an #allergy the @pfizer #CovidVaccine.
3/ There is even very little that we think could cause an #allergy in this @pfizer vaccine. But 2 patients had #anaphylaxis after vaccination and we need to think about why. Something epidemiologically different in the UK population compared to clinical trial populations?
Read 12 tweets
Kimberly Blumenthal, MD, MSc Profile picture
9 Dec 20
1/OK so there *may* be new reports of allergy to #COVID19 vaccines but many other things (e.g., vasovagal syncope) can be misdiagnosed as allergy so we need more clinical details from the UK
cnn.com/2020/12/09/hea…
2/ BUT, it is not surprising that allergic reactions might be identified during massive vaccination but not clinical trials because #allergy to vaccines are exceedingly rare (1 per million). In the @US_FDA report, AEs within 30 min for vaccine vs placebo were similar: Image
3/Most vaccine allergies come from the excipients and allergists can do skin testing to the vaccine and its excipients (often facilitating safe and totally unremarkable vaccination). Excipients are often shared for many approved vaccines: cdc.gov/vaccines/pubs/…
Read 10 tweets
Kimberly Blumenthal, MD, MSc Profile picture
7 Dec 20
I am excited for America and #publichealth that my mentor, @RWalensky will be leading the @CDCgov — she is a professor @harvardmed, an #NIH funded scientist, no stranger to testifying in congress, leader of @mgh_id,
mentor to so many(a few here: @KelliOLaughlin @EmilyHyle @ericashenoy @aciaranello @zach_wallace_md @ChanaSacks) including taking on me — an #alergist @AAAAI_org @AaaaiFoundation, but also a superhuman role model for all who prioritizes family @LorenWalensky #momofthreeboys
boston.com/news/coronavir…
Read 4 tweets

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