Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis
Background/Objectives: Vaccines have been recognized as one of the most effective public health interventions. However, vaccine-associated anaphylaxis, although rare, is a serious adverse reaction. The incidence of anaphylaxis related to non-COVID-19 vaccines in adults remains underreported. This sy...
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MDPI AG
2025-01-01
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| Series: | Vaccines |
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| Online Access: | https://www.mdpi.com/2076-393X/13/1/37 |
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| author | Flavia Pennisi Anna Carole D’Amelio Rita Cuciniello Stefania Borlini Luigi Mirzaian Giovanni Emanuele Ricciardi Massimo Minerva Vincenza Gianfredi Carlo Signorelli |
| author_facet | Flavia Pennisi Anna Carole D’Amelio Rita Cuciniello Stefania Borlini Luigi Mirzaian Giovanni Emanuele Ricciardi Massimo Minerva Vincenza Gianfredi Carlo Signorelli |
| author_sort | Flavia Pennisi |
| collection | DOAJ |
| description | Background/Objectives: Vaccines have been recognized as one of the most effective public health interventions. However, vaccine-associated anaphylaxis, although rare, is a serious adverse reaction. The incidence of anaphylaxis related to non-COVID-19 vaccines in adults remains underreported. This systematic review and meta-analysis aim to estimate the incidence of post-vaccination anaphylaxis across various vaccines in adults. Methods: A comprehensive literature search of PubMed, Embase, Scopus, and Web of Science identified studies on anaphylaxis following vaccination in adults (≥18 years), excluding COVID-19 vaccines. PRISMA 2020 guidelines were followed. The protocol was registered in PROSPERO in advance (ID CRD42024566928). Random-effects and fixed-effects models were used to pool data and estimate the logit proportion, with the logit-transformed proportion serving as the effect size, thereby allowing for the calculation of event rates. Results: A total of 37 studies were included in the systematic review, with 22 studies contributing to the meta-analysis, representing a combined population of 206,855,261 participants. Most studies focused on influenza vaccines (<i>n</i> = 15). Across all studies, 262 anaphylactic cases were reported, with 153 cases related to influenza vaccines, followed by herpes zoster virus vaccines (38 cases) and yellow fever vaccines (29 cases). Td/Tdap vaccine had the lowest rate (0.0001 per 100,000 participants). The overall random-effects model yielded a logit proportion of −10.45 (95% CI: −12.09 to −8.82, <i>p</i> < 0.001), corresponding to an event rate of 2.91 events per 100,000 subjects (95% CI: 0.56 to 14.73). Sensitivity analysis showed a higher incidence for influenza, hepatitis vaccines, and in vulnerable populations. Conclusions: Anaphylaxis following vaccination in adults is rare but varies by vaccine type. Strengthened monitoring and preparedness are essential, especially in non-medical settings, to ensure a rapid response to anaphylaxis and maintain public confidence in vaccination programs. |
| format | Article |
| id | doaj-art-b88e47826a38459e9065ddfa93e704f7 |
| institution | Kabale University |
| issn | 2076-393X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Vaccines |
| spelling | doaj-art-b88e47826a38459e9065ddfa93e704f72025-01-24T13:51:44ZengMDPI AGVaccines2076-393X2025-01-011313710.3390/vaccines13010037Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-AnalysisFlavia Pennisi0Anna Carole D’Amelio1Rita Cuciniello2Stefania Borlini3Luigi Mirzaian4Giovanni Emanuele Ricciardi5Massimo Minerva6Vincenza Gianfredi7Carlo Signorelli8PhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalyPhD National Programme in One Health Approaches to Infectious Diseases and Life Science Research, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalyDepartment of Biomedical Sciences for Health, University of Milan, Via Pascal, 36, 20133 Milan, ItalySchool of Medicine, Università Vita-Salute San Raffaele, 20132 Milan, ItalyBackground/Objectives: Vaccines have been recognized as one of the most effective public health interventions. However, vaccine-associated anaphylaxis, although rare, is a serious adverse reaction. The incidence of anaphylaxis related to non-COVID-19 vaccines in adults remains underreported. This systematic review and meta-analysis aim to estimate the incidence of post-vaccination anaphylaxis across various vaccines in adults. Methods: A comprehensive literature search of PubMed, Embase, Scopus, and Web of Science identified studies on anaphylaxis following vaccination in adults (≥18 years), excluding COVID-19 vaccines. PRISMA 2020 guidelines were followed. The protocol was registered in PROSPERO in advance (ID CRD42024566928). Random-effects and fixed-effects models were used to pool data and estimate the logit proportion, with the logit-transformed proportion serving as the effect size, thereby allowing for the calculation of event rates. Results: A total of 37 studies were included in the systematic review, with 22 studies contributing to the meta-analysis, representing a combined population of 206,855,261 participants. Most studies focused on influenza vaccines (<i>n</i> = 15). Across all studies, 262 anaphylactic cases were reported, with 153 cases related to influenza vaccines, followed by herpes zoster virus vaccines (38 cases) and yellow fever vaccines (29 cases). Td/Tdap vaccine had the lowest rate (0.0001 per 100,000 participants). The overall random-effects model yielded a logit proportion of −10.45 (95% CI: −12.09 to −8.82, <i>p</i> < 0.001), corresponding to an event rate of 2.91 events per 100,000 subjects (95% CI: 0.56 to 14.73). Sensitivity analysis showed a higher incidence for influenza, hepatitis vaccines, and in vulnerable populations. Conclusions: Anaphylaxis following vaccination in adults is rare but varies by vaccine type. Strengthened monitoring and preparedness are essential, especially in non-medical settings, to ensure a rapid response to anaphylaxis and maintain public confidence in vaccination programs.https://www.mdpi.com/2076-393X/13/1/37anaphylaxisvaccinespublic healthimmunizationhealth policy |
| spellingShingle | Flavia Pennisi Anna Carole D’Amelio Rita Cuciniello Stefania Borlini Luigi Mirzaian Giovanni Emanuele Ricciardi Massimo Minerva Vincenza Gianfredi Carlo Signorelli Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis Vaccines anaphylaxis vaccines public health immunization health policy |
| title | Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis |
| title_full | Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis |
| title_fullStr | Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis |
| title_short | Post-Vaccination Anaphylaxis in Adults: A Systematic Review and Meta-Analysis |
| title_sort | post vaccination anaphylaxis in adults a systematic review and meta analysis |
| topic | anaphylaxis vaccines public health immunization health policy |
| url | https://www.mdpi.com/2076-393X/13/1/37 |
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