The following is a summary of “Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study,” published in the November 2023 issue of Allergy & Immunology by Kocatürk, et al.

Patients with chronic urticaria (CU) often express concerns about potential disease exacerbations and adverse reactions when receiving COVID-19 vaccinations. For a study, researchers sought to evaluate the frequency of CU exacerbation and adverse reactions following COVID-19 vaccination in CU patients and identify associated risk factors.

The COVAC-CU study, conducted at international Urticaria Centers of Reference and Excellence (UCAREs), retrospectively analyzed the impact of COVID-19 vaccination on CU patients aged 18 and older who had received at least one dose of any COVID-19 vaccine. The study examined the occurrence of CU exacerbations, severe allergic reactions, and other vaccine-related adverse events, as well as their correlation with various CU parameters.

Among the 2,769 COVID-19 vaccinated CU patients, the majority (90%) had received at least two vaccine doses, were undergoing CU treatment, and had well-managed disease. The study found 9% of patients experienced CU exacerbations due to COVID-19 vaccination. In patients who developed CU exacerbations following the first dose, more than half (53.4%) had a recurrence of exacerbations after the second dose. These exacerbations often began within 48 hours post-vaccination (59.2%), typically lasted for a few weeks or less (70%), and were predominantly treated with antihistamines (70.3%). Several risk factors for COVID-19 vaccination-induced CU exacerbation were identified, including female sex, shorter disease duration (less than 24 months), chronic spontaneous urticaria (compared to inducible urticaria), receiving adenovirus viral vector vaccines, nonsteroidal anti-inflammatory drug/aspirin intolerance, and vaccine-related concerns. Conversely, receiving omalizumab treatment and Latino/Hispanic ethnicity were associated with a lower risk of exacerbation. The study also noted that vaccine-related adverse effects following the first dose were reported by 43.5% of CU patients, with local reactions, fever, fatigue, and muscle pain being the most common. Severe allergic reactions were reported by seven patients.

The study suggested that COVID-19 vaccination is generally well-tolerated among CU patients, with only a small percentage experiencing disease exacerbation.

Source: jacionline.org/article/S0091-6749(23)00986-7/fulltext