Characteristics of the patients consulted with emergency medicine physicians at a large-scale COVID-19 vaccination center: Prospective observational study
DOI:
https://doi.org/10.5055/ajdm.0456Keywords:
coronavirus disease 2019 vaccination, emergency medicine physician, adverse events, blood pressure, respiratory rateAbstract
Objective: We aimed to clarify the characteristics of patients consulted by the medical staff with emergency medicine (EM) physicians after vaccination and EM physicians transferred to an outside hospital.
Design: The Japanese Self-Defense Force established a large-scale coronavirus disease 2019 (COVID-19) vaccination center. Overall, 1,306,928 citizens received the Moderna vaccine, which targeted the first and second vaccinations between May 24, 2021 and November 30, 2021. EM physicians were always available in the emergency room (ER). The medical staff could consult the patients with EM physicians; however, the criteria were ambiguous. We conducted signal detection analysis on the patients who experienced adverse events to detect characteristics.
Results: Of the 3,312 patients experienced adverse events after vaccination, the medical staff consulted 344 with EM physicians. The patients whose respiratory rate and systolic blood pressure (BP) were more than 18 per minute and 162 mmHg, respectively, were considerably consulted. In addition, the patients whose systolic BP was more than 186.5 mmHg were transferred to an outside hospital. No patients were seriously ill or died after being transferred to an outside hospital.
Conclusions: The medical staff consulted the patients with a high respiratory rate or BP with EM physicians. In addition to BP, the respiratory rate would also be necessary as a finding that suggests a patient’s severity after vaccination. Therefore, it appears safer that EM physicians are always available to ensure the recipients’ safety when running a new large-scale vaccination center against unknown diseases, such as COVID-19.
References
Baden LR, El Sahly HM, Essink B, et al.: Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine. N Engl J Med. 2021; 384: 403-416.
Polack FP, Thomas SJ, Kitchin N, et al.: Safety and efficacy of the BNT162b2 mRNA COVID-19 vaccine. N Engl J Med. 2020; 383: 2603-2615.
Klein NP, Lewis N, Goddard K, et al.: Surveillance for adverse events after COVID-19 mRNA vaccination. JAMA. 2021; 326: 1390-1399.
Anand P, Stahel VP: Review the safety of COVID-19 mRNA vaccines: A review. Patient Saf Surg. 2021; 15(20): 33933145.
Wu Q, Dudley MZ, Chen X, et al.: Evaluation of the safety profile of COVID-19 vaccines: A rapid review. BMC Med. 2021; 19: 173.
Ali K, Berman G, Zhou H, et al.: Evaluation of mRNA-1273 SARSCoV-2 vaccine in adolescents. N Engl J Med. 2021; 385: 2241-2251.
Anderson EJ, Rouphael NG, Widge AT, et al.: Safety and immunogenicity of SARS-CoV-2 mRNA-1273 vaccine in older adults. N Engl J Med. 2020; 383: 2427-2438.
Blakeway H, Prasad S, Kalafat E, et al.: COVID-19 vaccination during pregnancy: Coverage and safety. Am J Obstet Gynecol. 2022; 226: 236.e231-236.e214.
Meylan S, Livio F, Foerster M, et al.: Stage III hypertension in patients after mRNA-based SARS-CoV-2 vaccination. Hypertension. 2021; 77: e56-e57.
Zappa M, Verdecchia P, Spanevello A, et al.: Blood pressure increase after Pfizer/BioNTech SARS-CoV-2 vaccine. Eur J Intern Med. 2021; 90: 111-113.
Imai K, Tanaka F, Kawano S, et al.: Incidence and risk factors of immediate hypersensitivity reactions and immunization stress-related responses with COVID-19 mRNA vaccine. J Allergy Clin Immunol Pract. 2022; 10: 2667-2676.e10.
El Sahly HM, Baden LR, Essink B, et al.: Efficacy of the mRNA-1273 SARS-CoV-2 vaccine at completion of blinded phase. N Engl J Med. 2021; 385: 1774-1785.
Cabanillas B, Novak N: Allergy to COVID-19 vaccines: A current update. Allergol Int. 2021; 70: 313-318.
Kim MS, Jung SY, Ahn JG, et al.: Comparative safety of mRNA COVID-19 vaccines to influenza vaccines: A pharmacovigilance analysis using WHO international database. J Med Virol. 2022; 94: 1085-1095.
Shiravi AA, Ardekani A, Sheikhbahaei E, et al.: Cardiovascular complications of SARS-CoV-2 vaccines: An overview. Cardiol Ther. 2022; 11: 13-21.
Cines DB, Bussel JB: SARS-CoV-2 vaccine-induced immune thrombotic thrombocytopenia. N Engl J Med. 2021; 384: 2254-2256.
Diaz GA, Parsons GT, Gering SK, et al.: Myocarditis and pericarditis after vaccination for COVID-19. JAMA. 2021; 326: 1210-1212.
Jani C, Leavitt J, Al Omari O, et al.: COVID-19 vaccine-associated Takotsubo cardiomyopathy. Am J Ther. 2021; 28: 361-364.
Loosen SH, Bohlken J, Weber K, et al.: Factors associated with non-severe adverse reactions after vaccination against SARS-CoV-2: A cohort study of 908,869 outpatient vaccinations in Germany. Vaccines. 2022; 10: 566.
Zou C, Xue X, Qian J: Characteristics and comparison of adverse events of coronavirus disease 2019 vaccines reported to the United States vaccine adverse event reporting system between 14 December 2020 and 8 October 2021. Front Med. 2022; 9: 826327.
Kewan T, Flores M, Mushtaq K, et al.: Characteristics and outcomes of adverse events after COVID-19 vaccination. JACEP Open. 2021; 2: E12565.
Usman OA, Usman AA, Ward MA: Comparison of SIRS, qSOFA, and NEWS for the early identification of sepsis in the emergency department. Am J Emerg Med. 2019; 37: 1490-1497.
Furuto Y, Nohara T, Hamada H, et al.: Hypertensive anaphylaxis after Moderna COVID-19 vaccination: A case report. Cureus. 2022; 14: E25586.
Vasireddy D, Vanaparthy R, Mohan G, et al.: Review of COVID-19 variants and COVID-19 vaccine efficacy: What the clinician should know? J Clin Med Res. 2021; 13: 317-325.
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