{Reference Type}: Journal Article
{Title}: The impact of COVID-19 vaccine reactions on secondary vaccine hesitancy.
{Author}: Freeman EE;Strahan AG;Smith LR;Judd AD;Samarakoon U;Chen G;King AJ;Blumenthal KG;
{Journal}: Ann Allergy Asthma Immunol
{Volume}: 132
{Issue}: 5
{Year}: 2024 May 16
{Factor}: 6.248
{DOI}: 10.1016/j.anai.2024.01.009
{Abstract}: <B>BACKGROUND: </B>Primary and booster vaccinations are critical for mitigating COVID-19 transmission, morbidity, and mortality. Future booster vaccine campaigns rely on an increased understanding of vaccine hesitancy.<BR><B>OBJECTIVE: </B>To evaluate self-reported allergic and skin vaccine reactions as factors potentially associated with vaccine hesitancy in a nationwide vaccine allergy registry.<BR><B>METHODS: </B>Responses to survey questions concerning COVID-19 vaccine perceptions, coded from free text by 2 independent reviewers. Multivariable logistic regression models were used to determine the association between changed negative perception and respondent demographics, vaccination history, and reaction characteristics.<BR><B>RESULTS: </B>A total of 993 individuals (median of 46 years [IQR, 36-59], 88% female, 82% White) self-reported reactions to COVID-19 vaccination. Reactions included the following: delayed large local skin reaction (40%), hives/urticaria (32%), immediate large local skin reaction (3%), swelling (3%), anaphylaxis (2%), and other or unspecified (20%). Most respondents were initially unconcerned about the safety of COVID-19 vaccines (56%). After reactions, 401 of 993 (40%) report negative change in perception of vaccination, with more than half of these respondents (n = 211, 53%) citing their reasoning as a negative experience with adverse effects. Of 102 individuals asked about future vaccination, 79 (77%) indicated that they were unlikely or very unlikely to receive future COVID-19 vaccinations. Increased negative perception after reaction was associated with younger age, later COVID-19 vaccination dose number, and reaction type.<BR><B>CONCLUSIONS: </B>Our findings reveal that an individual's experience with allergic or cutaneous adverse effects after COVID-19 vaccination affects attitudes and decision-making regarding future vaccination, even in initially non-hesitant individuals. Further investigation of secondary vaccine hesitancy is necessary for adapting public health messaging to this important population.