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. 2019 Jul;144(1):129-134.
doi: 10.1016/j.jaci.2019.01.029. Epub 2019 Feb 2.

Mining social media data to assess the risk of skin and soft tissue infections from allergen immunotherapy

Kimberly G Blumenthal  1 , Maxim Topaz  2 , Li Zhou  3 , Tyler Harkness  4 , Roee Sa'adon  5 , Ofrit Bar-Bachar  6 , Aidan A Long  7
Affiliations

Mining social media data to assess the risk of skin and soft tissue infections from allergen immunotherapy

Kimberly G Blumenthal et al. J Allergy Clin Immunol. 2019 Jul.

Abstract

Background: Allergen immunotherapy (AIT) treatment for allergic rhinitis and asthma is used by 2.6 million Americans annually. Clinical and sterility testing studies identify no risk of contamination or infection from extracts prepared using recommended aseptic techniques, but regulatory concerns persist. Social media can be used to investigate rare adverse effects not captured by traditional studies.

Objective: We sought to investigate large social media databases for suggestion of AIT skin and soft tissue infection (SSTI) risk and compare this risk to a comparator procedure with a sterile pharmaceutical.

Methods: We analyzed US-restricted data from more than 10 common text-based social media platforms including Facebook, Twitter, and Reddit between 2012 and 2016. We used natural language processing (NLP) to identify posts related to AIT and, separately, influenza vaccination (comparator procedure). NLP was followed by manual review to identify posts suggesting a possible SSTI associated with either AIT or influenza vaccination. SSTI frequencies with 95% CIs were compared.

Results: We identified 25,126 AIT posts, which were matched by social media platform to 25,126 influenza vaccination-related posts. NLP identified 4088 (16.3%) AIT posts that required manual review, with 6 posts (0.02%; 95% CI, 0.005%-0.043%) indicative of possible AIT-related SSTI. NLP identified 2689 (10.7%) influenza posts that required manual review, with 7 posts (0.03%; 95% CI, 0.007%-0.048%) indicative of possible influenza vaccination-related SSTI.

Conclusions: Social media data suggest that SSTI from AIT and influenza vaccination are equally rare events. Given that AIT's SSTI risk appears comparable to the risk using a sterile pharmaceutical based on social media data, current aseptic technique procedures seem safe.

Keywords: Informatics; NLP; allergen immunotherapy; aseptic; compounding; infection; influenza; posts; preparation; safety; shot; vaccination.

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Figures

Figure 1
Figure 1
Social media posts with possible skin or soft tissue infections due to allergen immunotherapy (A) and Influenza vaccinations (B). * This post likely represents a large local reaction, but was included as an SSTI because antibiotics were given. † This post may describe infectious symptoms unrelated to the allergy shot, but symptoms may describe a cellulitis or an upper respiratory infection.
Figure 1
Figure 1
Social media posts with possible skin or soft tissue infections due to allergen immunotherapy (A) and Influenza vaccinations (B). * This post likely represents a large local reaction, but was included as an SSTI because antibiotics were given. † This post may describe infectious symptoms unrelated to the allergy shot, but symptoms may describe a cellulitis or an upper respiratory infection.
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