(042) Self-Reported Mental Health Symptoms Among Patients With a Systemic Allergic Reaction to the COVID-19 Vaccine

Abstract:

Background: Sparse evidence suggests that patients experience anxiety related to allergic reactions (Brzyski et al., 2019). Mental health disorders, including anxiety and depression, have been found at higher rates in individuals with a history of allergic disorders (Jarosz et al., 2020). There is currently no available option for those who had an allergic reaction to the first dose of the mRNA COVID-19 vaccine to receive a second vaccine dose (CDC, 2022). Understanding the emotional experience of allergic reactions to vaccinations can inform public health safety strategies.



Methods: The National Institute of Allergy and Infectious Disease (NIAID) Covid Vaccine Allergy Reaction (COVAAR) study is a randomized, placebo-controlled crossover study to assess the safety of administering a second mRNA-based COVID-19 vaccine dose in individuals who experienced a systemic allergic reaction to an initial dose. The National Institutes of Health (NIH) psychiatry consultation-liaison service (PCLS) and the NIAID study teams measured participant’s anxiety levels and mental health characteristics over six months. Before admission for placebo-controlled vaccine administration, patients completed baseline mental health questionnaires, including anxiety rating scale, mental health history questionnaire, GAD-7, STAI, WHODAS 2, and IES-6. Subjects also participated in a semi-structured interview and PHQ-9 with a C-L psychiatrist via telehealth. Patients received brief written information for relaxation during their admission. At each study visit, patients rated their current anxiety level. Participants completed the battery of mental health surveys at one-month and four-month follow-up visits. Participants also provided feedback through a short questionnaire to assess their experience with the mental health portion of the study. Descriptive analyses identified sample demographics, mental health history, and anxiety levels.



Results: The primary outcome will be participant anxiety levels throughout the study as determined by the anxiety rating scale. Demographics and mental health characteristics of the participants, acceptability of mental health measures, and reactions to the second vaccine will be described.



Conclusion: Vaccine allergic reactions are potentially distressing and pose a barrier to future vaccination. In this study, participants with a prior systemic allergic reaction to the COVID-19 vaccine safely received a second vaccine dose under supervision of a supportive medical team. Regardless of past psychiatric history and anxiety levels, controlled administration of the second COVID-19 vaccine dose was feasible and enhanced with the support of C-L psychiatrists.





References:

Brzyski P, Cichocka-Jarosz E, Tarczoń I, Jedynak-Wąsowicz U, Tomasik T, Lis G. Health-related quality of life in children and adolescents after systemic sting reaction. Ann Agric Environ Med. 2019 Mar 22;26(1):103-108. doi: 10.26444/aaem/93747. Epub 2018 Sep 19. PMID: 30922038.

Jarosz M, Syed S, Błachut M, Badura Brzoza K. Emotional distress and quality of life in allergic diseases. Wiad Lek. 2020;73(2):370-373. PMID: 32248177.

Centers for Disease Control and Prevention. (2022, February 3). Allergic reactions after COVID-19 Vaccination. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/allergic-reaction.html#:~:text=If%20you%20had%20a%20severe%20allergic%20reaction%20after%20receiving%20a,Pfizer%2DBioNTech%20or%20Moderna).