Clinical Considerations: Myocarditis and Pericarditis after Receipt of mRNA COVID-19 Vaccines Among Adolescents and Young Adults (CDC)
Since April 2021, increased cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination (Pfizer-BioNTech and Moderna), particularly in adolescents and young adults. There has not been a similar reporting pattern observed after receipt of the Janssen COVID-19 Vaccine (Johnson & Johnson). In most cases, patients who presented for medical care have responded well to medications and rest and had prompt improvement of symptoms. Reported cases have occurred predominantly in male adolescents and young adults 16 years of age and older. Onset was typically within several days after mRNA COVID-19 vaccination, and cases have occurred more often after the second dose than the first dose. CDC and its partners are investigating these reports of myocarditis and pericarditis following mRNA COVID-19 vaccination.CDC continues to recommend COVID-19 vaccination for everyone 12 years of age and older given the risk of COVID-19 illness and related, possibly severe complications, such as long-term health problems, hospitalization, and even death.
Key Takeaways: Thrombosis with Thrombocytopenia Syndrome
American Society of Hematology (April 29, 2021)
This FAQ is designed to provide an overview of considerations around the diagnosis and treatment of TTS and will be updated as more information becomes available. Hematologists with expertise in hemostasis should be consulted as soon as TTS is diagnosed or under consideration, and many institutions will devise algorithms based on local laboratory testing availability and practices.
Webinar: Triage & Treatment of Patients with Potential Vaccine-induced Immune Thrombocytopenia (VITT) Post J&J COVID-19 Vaccination
CDC/American Society of Hematology (April 20, 2021)
Rare cases of thrombosis with thrombocytopenia have been reported following vaccination with the Johnson & Johnson/Janssen COVID-19 vaccine. A recent one-hour seminar reviewed the background, diagnosis, and clinical management of this emerging disorder with experts from Centers for Disease Control (CDC) and the American Society of Hematology. The seminar also covered how to report cases through CDC’s Vaccine Adverse Events Reporting System (VAERS).
Janssen COVID-19 Updated Guidance
Emergency Use Authorization (EUA) Fact Sheets and Prescribing Information for the Janssen COVID-19 Vaccine have been updated to reflect new data obtained from post authorization experience and an ongoing clinical trial. Healthcare professionals should be alert to the signs and symptoms of thrombosis with thrombocytopenia in individuals who receive the Janssen COVID-19 Vaccine.
Clinical Care Considerations for COVID-19 Vaccination (CDC)
The Advisory Committee on Immunization Practices (ACIP) has issued interim recommendations for the use of Pfizer-BioNTech, Moderna, and Janssen/Johnson & Johnson COVID-19 vaccines for the prevention of coronavirus disease 2019 (COVID-19) in the United States. You can find these recommendations as well as clinical considerations for managing adverse events here.
Interim Considerations: Preparing for the Potential Management of Anaphylaxis after COVID-19 Vaccination (CDC)
Under the Emergency Use Authorizations for COVID-19 vaccines, appropriate medical treatment for severe allergic reactions must be immediately available in the event that an acute anaphylactic reaction occurs following administration of a COVID-19 vaccine. These interim considerations provide information on preparing for the initial assessment and management of anaphylaxis following COVID-19 vaccination.
COVID-19 CISA Clinical Consultation
Healthcare providers or health departments in the United States can request a consultation from CISA COVIDvax for a complex COVID-19 vaccine safety question that is (1) about an individual patient residing in the United States or vaccine safety issue and (2) not readily addressed by CDC or Advisory Committee on Immunization Practices (ACIP) guidelines.
ACAAI Updates to Guidance on Risk of Allergic Reactions to COVID-19 Vaccines
The American College of Allergy, Asthma and Immunology (ACAAI) COVID-19 Vaccine Task Force continues to closely monitor information from sources reporting on allergic reactions to the COVID-19 vaccines. As such, ACAAI has updated its guidance to reflect the most recent recommendations from the CDC and the FDA. (Updated March 21, 2021)
Insights from American College of Allergy, Asthma, and Immunology COVID-19 Vaccine Task Force: Allergic Reactions to mRNA SARS-CoV-2 Vaccines (Annals of Allergy, Asthma & Immunology, January 22, 2021)
The evaluation of at-risk patients should be individualized. As part of that evaluation, one should use shared decision-making surrounding the approach to testing and future vaccination. It is vital that patients understand the overall benefit of vaccination against SARS-CoV-2 in relation to the extremely low overall risk of an allergic reaction. Allergists/immunologists are uniquely qualified to guide their patients and educate the public during this extensive vaccine campaign and assist in bringing this pandemic to an end by achieving adequate herd immunity.
COVID-19 Vaccine FAQs: Information for Clinicians (Vaccine ingredients, PEG)
(American College of Allergy, Asthma & Immunology, Updated March 24, 2021)