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What are anaphylactoid reactions to the Pfizer vaccine and why have they occurred?

Margaret Keenan, a charming 90-year-old woman from the city of Coventry, became the first person in the world to receive the vaccine against COVID-19 from the American pharmaceutical company Pfizer and the German company BionTech. With his mask and his nice pajamas, he left a curious picture that will take time to fade from the retinas of a citizenry that yearns for an antidote to stop the advance of the coronavirus pandemic. However, this hopeful image has been overshadowed this Wednesday by the British Government’s announcement of the adverse reaction of two toilets to the drug.

Second day of vaccinations against coronavirus in the UK.  Today the inoculation of the British over 80 years and other groups considered vulnerable has continued. "I only felt a slight pinch, nothing more"says an old man after receiving his dose.  Pfizer and BionNtech's vaccine inoculation plans are being developed as planned and taking into account specifications, such as keeping cold to minus 80 degrees below zero. "We have brought a special freezer"says Charlotte Forsyth, Medical Director of Great Western Hospital.  Forsyth also says that the doses have to be removed an hour before being administered and that has required a lot of training from the nursing staff.  Amanda, nurse tells that" It was a bit intense, for being the first time, but everything went well".  The UK has purchased 20 million vaccines from Pfizer / BioNtech to supply in two doses over the next few months.

The UK Medicines and Healthcare Products Regulatory Agency (MHRA) has issued a warning stating that people with a history of “significant” allergic reactions to other vaccines, drugs or foods should not receive the compound from Pfizer against COVID-19.

This notice comes after two UK National Health System (NHS) workers submitted “anaphylactoid reactions” after receiving the vaccine, as reported by the national director in England of this health agency, Stephen Powis. But what are these responses? They are sudden and generalized systemic reactions that affect several organs at the same time and can put the life of those who suffer them at risk.

“An anaphylactic reaction is an allergic reaction of the body to a substance mediated by an antibody called immunoglobulin E (IgE), in which the immune system makes a mistake and recognizes something that does not have to be as potentially harmful. Anaphylactoids are very similar, but it cannot be shown that the process is mediated by this immunoglobulin“, explains the secretary of the Spanish Society of Immunology (SEI), Carmen Cámara.

“It has occurred in two individuals with a previous history of reactions to other medications, since both had adrenaline to inject themselves”

These responses occur immediately and manifest with breathing difficulties, choking, hives, facial burning sensation, low blood pressure and even cardiac arrest, which can cause the patient to become unconscious and fall to the ground. Treatment, which must be imminent, is based on corticosteroids and antihistamines and, if there is no response, with adrenaline, details Camera.

An unusual response to vaccines

Regarding the frequency with which similar cases can be expected to appear among those who undergo vaccination, the immunologist notes that these reactions to drugs, including vaccines, “They are very rare, but they exist”. “Their appearance is something that can be predicted within any new drug that is beginning to be administered to the population,” he adds.

Authorities inspect the development of the COVID-19 vaccine from the Chinese biotech company Sinovac, in a company laboratory in Beijing, China.

“It does seem, from what little we know, is that it has occurred in two individuals with a previous history of reactions to other medications, since both had adrenaline to inject themselves. They had a clear predisposition to have this response, it is not in a normal population Although it can occur in anyone, it is very very unlikely“he adds.

In the same vein, Susana Ranea, an allergist at Doctoralia, is pronounced, who admits to be perplexed by the appearance of this type of response, since most of the potential components of a vaccine that can produce an allergic reaction have not been used in the from Pfizer, he points out. Therefore, it emphasizes the need to clarify the conditions in which these cases have developed.

“You have to explain what the symptoms have consisted of, what type of reaction they have presented, how long it has occurred … because It’s very weird that among 44,000 volunteers there were no cases and in a vaccination day two appear, “he insists. Regarding this last point, it should be noted that the Pfizer trial protocol prohibited the participation of individuals with a history of severe allergic responses to other vaccines or compounds.

Has the British Government done well?

These adverse reactions from the two health workers have led the British Government to recommend that those who have had severe allergic reactions to vaccines, drugs or foods in the past avoid receiving the Pfizer compound for the time being. A decision that the Chamber qualifies as “first reaction at an unprecedented moment” and that it supposes that the British Executive will clarify as progress is made in the knowledge of what happened.

“It is very rare that among 44,000 volunteers there were no cases and in a vaccination day two appear”

“It is expected that things different from what happened in the clinical trial if we scale and go from 40,000 volunteers to 40 million people. In percentage terms there will be some more reaction. The important thing is that handle as well as this time, which has not had any consequences. So what you have to do is follow the recommendations, “he deepens.

Coronavirus vaccine.

More critical of the attitude of the United Kingdom Government is Ranea, who considers that these indications about who should wait to be vaccinated are too “vague” and “unspecific” and contribute to increasing “fear” and the reluctance of the population to receive the drug from Pfizer, especially among allergy sufferers, who constitute “up to 25% of the population.”

“What is a serious allergy? An asthmatic, a food allergic, one who has had a reaction to penicillin that surely is not? I find that the recommendations are too general, there are many people who do not want to be vaccinated, who have fear I am receiving messages everywhere on this subject with doubts. We are playing too much with all this to make this decision“, he estimates.

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