Safety Evaluation of the Second Dose of mRNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose | Allergy and Clinical Immunology | JN Learning | AMA Ed Hub [Skip to Content]
[Skip to Content Landing]

Safety Evaluation of the Second Dose of Messenger RNA COVID-19 Vaccines in Patients With Immediate Reactions to the First Dose

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Sign in to take quiz and track your certificates

Buy This Activity

JN Learning™ is the home for CME and MOC from the JAMA Network. Search by specialty or US state and earn AMA PRA Category 1 CME Credit™ from articles, audio, Clinical Challenges and more. Learn more about CME/MOC

CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: May 28, 2021.

Published Online: July 26, 2021. doi:10.1001/jamainternmed.2021.3779

Corresponding Author: Kimberly G. Blumenthal, MD, MSc, Massachusetts General Hospital, The Mongan Institute, 100 Cambridge St, 16th Floor, Boston, MA 02114 (kblumenthal@mgh.harvard.edu).

Author Contributions: Drs Krantz, Kwah, and Blumenthal had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. Drs Krantz and Kwah are co–first authors, and Drs Banerji and Blumenthal share senior authorship.

Concept and design: Krantz, Kwah, Stone, Phillips, Banerji, Blumenthal.

Acquisition, analysis, or interpretation of data: Krantz, Kwah, Stone, Phillips, Ortega, Blumenthal.

Drafting of the manuscript: Krantz, Kwah, Stone, Phillips, Blumenthal.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Krantz, Stone, Blumenthal.

Obtained funding: Phillips, Blumenthal.

Administrative, technical, or material support: Kwah, Stone, Phillips, Ortega, Banerji, Blumenthal.

Supervision: Krantz, Stone, Phillips, Banerji, Blumenthal.

Conflict of Interest Disclosures: Dr Stone reported grants from the Agency for Healthcare Research and Quality (AHRQ) during the conduct of the study. Dr Phillips reported personal fees from Janssen, Biocyst, Regeneron, Vertex, and UpToDate and grants from the National Institutes of Health (NIH) and grants from NHMRC Australia Monies to institution outside the submitted work. Dr Blumenthal reported grants from NIH/National Institute of Allergy and Infectious Diseases during the conduct of the study. No other disclosures were reported.

Funding/Support: This work was supported by NIH grant K01 AI125631 (Dr Blumenthal), AHRQ/Patient-Centered Outcomes Research Institute grant 1K12HS026395-01 (Dr Stone), and the Massachusetts General Hospital DOM Transformative Scholar Program (Dr Blumenthal).

Role of the Funder/Sponsor: The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH, AHRQ, or MGH.

Additional Contributions: We thank many colleagues at Massachusetts General Hospital (Lacey B. Robinson, MD, MPH, Anna R. Wolfson, MD, Rebecca R. Saff, MD, PhD, Upeka Samarakoon, PhD, MPH), Brigham and Women’s Hospital (Paige G. Wickner, MD, MPH, Lily Li, MD, David I. Hong, MD), Vanderbilt University Medical Center (Grace Koo, MD), Yale School of Medicine (John K. Kuster, MD, Christina C. Price, MD), and University of Texas Southwestern (David A. Khan, MD, Timothy G. Chow, MD, Rebecca Gruchalla, MD, PhD). We thank Christian M. Mancini, BS, Massachusetts General Hospital, for assistance with data analysis. No compensation was received by any of these individuals.

References
1.
Blumenthal  KG , Robinson  LB , Camargo  CA  Jr ,  et al.  Acute allergic reactions to mRNA COVID-19 vaccines   JAMA. 2021;325(15):1562-1565. doi:10.1001/jama.2021.3976PubMedGoogle ScholarCrossref
2.
US Centers for Disease and Control Prevention. Interim clinical considerations for use of mRNA COVID-19 vaccines. Accessed May 17, 2021. https://www.cdc.gov/vaccines/covid-19/info-by-product/clinical-considerations.html)
3.
Banerji  A , Wickner  PG , Saff  R ,  et al.  mRNA vaccines to prevent COVID-19 disease and reported allergic reactions: current evidence and suggested approach.   J Allergy Clin Immunol Pract. 2021;9(4):1423-1437. doi:10.1016/j.jaip.2020.12.047PubMedGoogle ScholarCrossref
4.
Rüggeberg  JU , Gold  MS , Bayas  JM ,  et al; Brighton Collaboration Anaphylaxis Working Group.  Anaphylaxis: case definition and guidelines for data collection, analysis, and presentation of immunization safety data.   Vaccine. 2007;25(31):5675-5684. doi:10.1016/j.vaccine.2007.02.064PubMedGoogle ScholarCrossref
5.
Sampson  HA , Muñoz-Furlong  A , Campbell  RL ,  et al.  Second symposium on the definition and management of anaphylaxis: summary report—Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium.   J Allergy Clin Immunol. 2006;117(2):391-397. doi:10.1016/j.jaci.2005.12.1303PubMedGoogle ScholarCrossref
6.
Castells  MC , Phillips  EJ .  Maintaining safety with SARS-CoV-2 vaccines.   N Engl J Med. 2021;384(7):643-649. doi:10.1056/NEJMra2035343PubMedGoogle ScholarCrossref
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
If you are not a JN Learning subscriber, you can either:
Subscribe to JN Learning for one year
Buy this activity
jn-learning_Modal_Multimedia_LoginSubscribe_Purchase
Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close

Name Your Search

Save Search
Close
With a personal account, you can:
  • Track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
jn-learning_Modal_SaveSearch_NoAccess_Purchase
Close

Lookup An Activity

or

Close

My Saved Searches

You currently have no searches saved.

Close
With a personal account, you can:
  • Access free activities and track your credits
  • Personalize content alerts
  • Customize your interests
  • Fully personalize your learning experience
Education Center Collection Sign In Modal Right
Close