Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2023 Nov;152(5):1095-1106.
doi: 10.1016/j.jaci.2023.07.019. Epub 2023 Aug 12.

Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Emek Kocatürk  1 , Pascale Salameh  2 , Esra Sarac  3 , Carolina E Vera Ayala  4 , Simon Francis Thomsen  5 , Torsten Zuberbier  4 , Luis Felipe Ensina  6 , Todor A Popov  7 , Martijn B A van Doorn  8 , Ana Maria Giménez-Arnau  9 , Riccardo Asero  10 , Paulo Ricardo Criado  11 , Fernando M Aarestrup  12 , Zainab AbdulHameed Ansari  13 , Salma Al Abri  13 , Mona Al-Ahmad  14 , Bushra Al Hinai  13 , Anastasiia Allenova  15 , Maryam Al-Nesf  16 , Sabine Altrichter  17 , Rand Arnaout  18 , Joanna Bartosińska  19 , Andrea Bauer  20 , Jonathan A Bernstein  21 , Mojca Bizjak  22 , Hanna Bonnekoh  4 , Laurence Bouillet  23 , Zenon Brzoza  24 , Ana Caroline Calvalcanti Dela Bianca Melo  25 , Fernanda L Campinhos  26 , Emily Carne  27 , Saleema Cherichi Purayil  16 , Ivan Cherrez-Ojeda  28 , Herberto Jose Chong-Neto  29 , George Christoff  30 , Niall Conlon  31 , Roberta Fachini Jardim Criado  11 , Klara Cvenkel  32 , Ebru Damadoglu  33 , Inna Danilycheva  34 , Cascia Day  35 , Laurence de Montjoye  36 , Semra Demir  37 , Silvia Mariel Ferucci  38 , Daria Fomina  39 , Atsushi Fukunaga  40 , Elizabeth Garcia  41 , Asli Gelincik  37 , Joe Hannah Göbel  4 , Kiran Godse  42 , Margarida Gonçalo  43 , Maia Gotua  44 , Clive Grattan  45 , Agata Gugala  46 , Carole Guillet  47 , Ali Fuat Kalyoncu  33 , Gul Karakaya  33 , Alicja Kasperska-Zając  48 , Constance H Katelaris  49 , Maryam Khoshkhui  50 , Andreas Kleinheinz  51 , Marta Kolacinska-Flont  52 , Pavel Kolkhir  4 , Mitja Košnik  22 , Dorota Krasowska  19 , Muthu Sendhil Kumaran  53 , Izabela Kuprys-Lipinska  52 , Marcin Kurowski  46 , Elizaveta V Kuznetsova  54 , Désirée Larenas-Linnemann  55 , Marina S Lebedkina  56 , Youngsoo Lee  57 , Michael Makris  58 , René Maximiliano Gómez  59 , Iman Nasr  13 , Sophia Neisinger  4 , Yoshiko Oda  60 , Rabia Öztaş Kara  61 , Esther Bastos Palitot  62 , Niki Papapostolou  58 , Claudio Alberto Salvador Parisi  63 , David Pesque  9 , Jonathan Peter  35 , Elena Petkova  64 , Katie Ridge  31 , Michael Rudenko  65 , Krzysztof Rutkowski  66 , Sarbjit S Saini  67 , Andac Salman  68 , Jorge Sanchez  69 , Bülent Şekerel  70 , Sofia A Serdotetskova  56 , Faradiba S Serpa  26 , Bahar Sevimli Dikicier  61 , Nikitas Sidiropoulos  58 , Agnieszka Sikora  48 , Jennifer Astrup Sørensen  5 , Angele Soria  71 , Ozlem Su Kucuk  72 , Sherin Rahim Thalappil  16 , Katarzyna Tomaszewska  73 , Gulseren Tuncay  33 , Derya Unal  37 , Solange Valle  74 , Esmee van Lindonk  75 , Christian Vestergaard  76 , Raisa Y Meshkova  77 , Aleksandr Vitchuk  78 , Paraskevi Xepapadaki  79 , Young-Min Ye  57 , Anna Zalewska-Janowska  73 , Mateusz Zamlynski  48 , Marcus Maurer  80
Affiliations
Multicenter Study

Urticaria exacerbations and adverse reactions in patients with chronic urticaria receiving COVID-19 vaccination: Results of the UCARE COVAC-CU study

Emek Kocatürk et al. J Allergy Clin Immunol. 2023 Nov.

Abstract

Background: Concern about disease exacerbations and fear of reactions after coronavirus disease 2019 (COVID-19) vaccinations are common in chronic urticaria (CU) patients and may lead to vaccine hesitancy.

Objective: We assessed the frequency and risk factors of CU exacerbation and adverse reactions in CU patients after COVID-19 vaccination.

Methods: COVAC-CU is an international multicenter study of Urticaria Centers of Reference and Excellence (UCAREs) that retrospectively evaluated the effects of COVID-19 vaccination in CU patients aged ≥18 years and vaccinated with ≥1 dose of any COVID-19 vaccine. We evaluated CU exacerbations and severe allergic reactions as well as other adverse events associated with COVID-19 vaccinations and their association with various CU parameters.

Results: Across 2769 COVID-19-vaccinated CU patients, most (90%) received at least 2 COVID-19 vaccine doses, and most patients received CU treatment and had well-controlled disease. The rate of COVID-19 vaccination-induced CU exacerbation was 9%. Of 223 patients with CU exacerbation after the first dose, 53.4% experienced recurrence of CU exacerbation after the second dose. CU exacerbation most often started <48 hours after vaccination (59.2%), lasted for a few weeks or less (70%), and was treated mainly with antihistamines (70.3%). Factors that increased the risk for COVID-19 vaccination-induced CU exacerbation included female sex, disease duration shorter than 24 months, having chronic spontaneous versus inducible urticaria, receipt of adenovirus viral vector vaccine, having nonsteroidal anti-inflammatory drug/aspirin intolerance, and having concerns about getting vaccinated; receiving omalizumab treatment and Latino/Hispanic ethnicity lowered the risk. First-dose vaccine-related adverse effects, most commonly local reactions, fever, fatigue, and muscle pain, were reported by 43.5% of CU patients. Seven patients reported severe allergic reactions.

Conclusions: COVID-19 vaccination leads to disease exacerbation in only a small number of CU patients and is generally well tolerated.

Keywords: Adverse effects; COVID-19; exacerbation; omalizumab; real life; treatment; urticaria; vaccination; vaccine; worsening.

PubMed Disclaimer

Publication types

Substances