Immunization with COVID-19 Moderna Vaccine

The overall incidence of AEFI was low at both first and second doses of the Moderna vaccine, the incidence rates of both IHSR and ISRR were significantly higher after the first dose than after the second one. Over 80% of AEFI incidences were ISRR, and the incidence rate of IHSR was low, with only ~266 cases per 240 million doses among vaccine recipients, at both first and second doses, which is different from the estimated incidence rates reported previously.

Consistent with the existing data reports for the US and UK, the anaphylaxis rate was also extremely low, at 2 cases per million doses. Only the female gender and history of allergy were associated with an increased risk of anaphylaxis to mRNA vaccines.

The researchers identified several risk factors associated with the development of IHSR and ISRR, including comorbidities such as asthma, atopic dermatitis, and thyroid diseases. The vaccine recipients with these comorbidities, including thyroid disorders, were predisposed to develop IHSR in response to mRNA vaccines, although their response may not be specific to mRNA vaccine components such as PEG-2000. People with thyroid disorders have a higher PEG-sensitisation rate than the general population.
In addition, ISRR-related clinical symptoms and signs, especially neurological symptoms, were difficult to assess in the setting of mass vaccination. However, one-third of recipients showed neurological symptoms, such as functional neurological disorders (FNDs), although active surveillance and careful evaluations are needed for a more accurate diagnosis and taking appropriate mitigating measures at mass vaccination centers.

To summarize, the risk factors identified in the present study could help stratify mRNA vaccine recipients at high risk of developing IHSR and ISRR and help healthcare providers take appropriate measures to prevent and respond adequately to their development in time.





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