An immediate allergic reaction following the anti-COVID-19 vaccine Pfizer-BioNTech : A case report

To date, the vaccine is the only weapon to stop the global pandemic caused by the SARS-CoV-2. But, several clinical cases of complications have been reported in the literature especially allergic reactions. We report a case of 35-year-old woman, known asthmatic with history of a chronic urticaria, an allergic rhinoconjunctivitis and an angioedema after taking NSAIDs. The patient presented 10 minutes after vaccination by Pfizer-BioNTech vaccine, an immediate allergic reaction complicated 12 hours after, by an angioedema. During the first wave of COVID-19, and after initiation of the vaccination program in Morocco, vaccinating people with severe allergies was not recommended. This reality was changed after the second wave of SARS-CoV-2 Delta, on condition of doing it under medical monitoring. We should propose to all risky persons to take a premedication if needed to avoid such reactions considering the benefits incurred. The use of anti-histamines seems to be necessary. But as in our patient’s case, anti-histamines alone were not sufficient to avoid this local reaction. They probably reduced the intensity of the reaction but did not avoid it. Therefore, we should propose a combination of drugs made by corticosteroids and anti-histamines as a premedication may be a safe alternative to the risky patients and last but not least a close monitoring should be proposed. The main purpose of this case if to raise awareness of this side effect among practitioners and make them capable to managing it correctly.