COVID-19 Update | January 8, 2021
Important Highlights
Based on early vaccine safety monitoring, anaphylaxis, a severe allergic reaction, following mRNA COVID-19 vaccination appears to be a rare event. However, anaphylaxis is clinically serious and requires immediate treatment. Through the Vaccine Adverse Event Reporting System (VAERS), CDC and FDA were able to rapidly detect the anaphylaxis cases, assess individual cases, and quantify the rate. Post-event follow-up indicates that the patients experiencing anaphylaxis all fully recovered following treatment. CDC then issued updated clinical practice guidance. This report demonstrates the robustness of the U.S. vaccine safety monitoring system. The safety system works and will continue to be used to monitor the safety of COVID-19 vaccines given to the public.
This report summarizes the clinical and epidemiologic characteristics of people with anaphylaxis and non-anaphylaxis allergic reactions following administration of a first dose of Pfizer-BioNTech COVID-19 vaccine during December 14-23, 2020, in the United States. As of December 23, 2020, an estimated 1,893,360 first doses Pfizer-BioNTech COVID-19 vaccine were administered in the United States. Afterwards, 4,393 adverse event reports on these vaccine recipients had been submitted to VAERS, and 175 had been identified on initial review for rapid evaluation for potential anaphylaxis. Of these reports, 21 were determined to be anaphylaxis; 86 were non-anaphylaxis allergic reactions; 61 were non-allergic adverse events; and 7 were under investigation. Post-event follow-up indicates that the patients experiencing anaphylaxis fully recovered following treatment.
Updated Contraindications and Precautions to mRNA COVID-19 Vaccination
  • On December 30, 2020, CDC issued updated interim clinical considerations for use of mRNA COVID-19 vaccines currently authorized in the United States and interim considerations on preparing for the  management of possible anaphylaxis cases at COVID-19 vaccination sites.
  • The updated contraindications and precautions to vaccination apply to both Pfizer-BioNTech and Moderna COVID-19 vaccines.
  • Guidance may change as further information becomes available.
  • Definition of immediate allergic reaction to vaccine or medication: Any hypersensitivity-related signs or symptoms such as hives, swelling under the skin, trouble breathing (e.g., wheezing, stridor), or anaphylaxis that occur within four hours of vaccine administration.
CDC encourages healthcare providers to:
  • Recognize, respond to, and report anaphylaxis following COVID-19 vaccination to VAERS,
  • Report adverse events to VAERS in accordance with FDA EUA reporting requirements and CDC guidance
  • Participate in CDC’s v-safe program when they are vaccinated and encourage patients to participate in v-safe
  • Work with sites administering COVID-19 vaccines to encourage adherence to CDC guidance for anaphylaxis, including having the necessary supplies available to manage anaphylaxis
  • Communicate with patients on vaccine safety
Technical Guidance, Standards and Resources
Infection Prevention and Control
Special Settings and Populations
AHRQ ECHO National Nursing Home COVID-19 Action Network (Project ECHO University of New Mexico) 
Testing and Cases
Information for Patients, Visitors, and the General Public
Event Announcements
Equity Lens Tool Launch for COVID-19 Response (Big Cities Health Coalition)
Jan. 11: 12 PM
This webinar is the launch for a new health equity tool to support health departments in more directly and routinely addressing equity in COVID-19 planning, response, and recovery decision making..
SPEAKERS: Lili Farhang, Heather Jue Northover, Gretchen Musicant
The Challenges of Aging During COVID-19: Long Term Care, Vaccination and Isolation (NIHCM Foundation)
Jan. 15, 1PM – 2PM PM ET
Overview of COVID-19’s challenges to long-term care and the future implications for nursing homes; Vaccination and vaccine distribution challenges for older adults; A health plan’s efforts to address pandemic isolation and loneliness
SPEAKERS: Vincent Mor, PhD, Paul Kaplan, MD, Tricia Neuman, ScD
Trade Press, Journal Articles and White Papers
Home health staff perspectives on infection prevention and control: implications for Coronavirus Disease 2019 
Pogorzelska-Maziarz M, Chastain AM, Mangal S, et al. J Am Med Dir Assoc. 2020;21(12):1782-1790.e4. 
Evaluation of Cloth Masks and Modified Procedure Masks as Personal Protective Equipment for the Public During the COVID-19 Pandemic 
SHEA Education and Events
New this week:
  1. Podcast: Perspectives from Healthcare Professionals Who Have Received the COVID-19 Vaccine
  2. Town Hall Round 37
    Sunday, January 10, 2021 | 3:00 pm ET
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