Is your Covid vaccination site prepared for rare, life-threatening reactions?

With the rise of Covid-19 vaccines in the U.S. moving from distribution in hospitals to pharmacies, pop-up locations, and drive-through clinics, it is vitally important that these expanded venues be limited to rare but potentially life-threatening ones, according to health experts Events are prepared for allergic reactions.

“You want to be able to treat anaphylaxis,” said Dr. Mitchell Grayson, an allergist and immunologist at Nationwide Children’s Hospital in Columbus, Ohio. “I hope you’re in a place where an ambulance can get there in five to ten minutes.”

Of the more than 6 million people in the US who have received shots of the two new Covid vaccines, at least 29 have suffered anaphylaxis, a severe and dangerous reaction that constricts the airways and turns the body into one, according to the Centers for Disease Going into shock can control and prevention.

Such incidents were rare – about 5.5 cases per million vaccine doses administered in the US between mid-December and early January – and patients recovered. For most people, the risk of contracting the coronavirus is far higher than the risk of a vaccine reaction and no reason to avoid the gunshots, Grayson said.

Still, the rate of anaphylaxis with covid vaccines is around five times higher than with flu shots, and some of those affected have not had any previous allergic reactions. At this early stage of vaccine implementation, all patients were treated in hospitals and health centers that could provide immediate access to full-service emergency care.

As states seek to increase the distribution, the shots are being administered by a variety of professionals at venues such as drug stores, dental offices, and temporary locations that include National Guard troops. Health officials say that any site involved in the wider rollout of the community needs to be able to spot problems and have the training and equipment to react quickly if something goes wrong.

“We go to great lengths to ensure that anyone who gives vaccines not only has to have the EpiPen available, but, frankly, knows how to use it,” said Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases. in a call with reporters. She was referring to a common adrenaline injector that many people with severe allergies carry with them. These health care workers also need to know the red flags of the need for advanced care, she added.

Anaphylaxis usually occurs within minutes and can cause hives, nausea, vomiting, dizziness or fainting, as well as life-threatening problems like low blood pressure and narrowed airways. The initial treatment is an injection of epinephrine, or epinephrine, to reduce the body’s allergic reaction. However, severely affected patients may need intensive treatments like oxygen, intravenous antihistamines, and steroids like cortisone to save their lives. Community websites likely do not have these treatments and need quick access to emergency responders.

Anyone giving vaccines not only needs to have the EpiPen available, they honestly need to know how to use it.

Dr. Nancy Messonnier, CDC

Scientists are still investigating what triggers the severe reactions to the Pfizer-BioNTech and Moderna mRNA vaccines. They suspect the culprit could be polyethylene glycol or PEG, a component found in both vaccines that has been linked to allergic reactions.

Even when calling for education and support for vendors, experts urge the more than 50 million Americans with allergies – whether to food, insecticide, medication, or other vaccines – to proactively find a place that is properly prepared. Before planning a vaccine, check out the website and ask specific questions about the emergency precautions, said Dr. Kimberly Blumenthal, Allergy Quality and Safety Officer at Massachusetts General Hospital.

“Ask the question: Do you have an anaphylaxis kit? Can you take signs of life? “She said. People who routinely wear EpiPens should remember to bring them with them if they are vaccinated,” she added.

A CDC website will provide a list of the devices and medications that should be available on the websites and it is highly recommended that all patients be observed for 15 minutes after vaccination or 30 minutes if they are at higher risk for reactions are. The list is recommended, but the sites should offer more intense treatments such as IV fluids. People with severe reactions shouldn’t get the recommended second dose of the vaccine, the agency said.

“In the event that an acute anaphylactic reaction occurs after an mRNA COVID-19 vaccine is administered, appropriate medical treatment for severe allergic reactions must be available immediately,” the website said.

Nonetheless, given the scale of the vaccination effort, this is a major challenge. The federal government sends vaccines to more than 40,000 pharmacy locations across 19 chains, including CVS, Walgreens, Costco and Rite Aid. At the same time, dozens of pop-up vaccination sites are being ramped up in New York, and transit clinics have been set up in Ohio, Florida, and other states.

Passage points in particular are a concern for allergy sufferers like Blumenthal, who said it was crucial to identify symptoms of anaphylaxis quickly. “If you’re in a car, will you open your windows? Where are the drugs? Are you in a parking lot “She said,” It just sounds logistically more challenging. “

Ask the question: Do you have an anaphylaxis kit? Can you take signs of life?

Dr. Kimberly Blumenthal, Massachusetts General Hospital

In Columbus, as of January 6, more than 2,400 people had been vaccinated in a transit clinic at the Ohio Expo Center. No allergic reactions have been reported, according to Kelli Newman, a spokeswoman for Columbus Public Health. But if they do occur, be prepared health officials.

“We have a partnership with our UMS and they monitor the vaccinated for 15 minutes to make sure there are no side effects,” Newman said in an email. “They have two ambulances with emergency equipment and adrenaline available if needed.”

Similarly, representatives from CVS Health and Walgreens said they had the staff and supplies to deal with “infrequent but severe” reactions.

“We have emergency management protocols that are required for all vaccine providers. After a clinical evaluation, we can deliver adrenaline, call 911 and deliver CPR if necessary,” said Rebekah Pajak, spokeswoman for Walgreens, in an email.

If there are appropriately trained personnel, supplies and equipment at the vaccination sites, the vast majority of people should opt for the shot, especially as the pandemic continues to worsen, said Dr. David Lang, past president of the American Academy of Allergy. Asthma & Immunology and Chairman of the Department of Immunology at Cleveland Clinic.

“The overwhelming chance is that you won’t have anaphylaxis and the overwhelming benefits far outweigh the risk of harm,” Lang said.

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