{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T12:27:38Z","timestamp":1762432058180},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"Special Issue_13","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,12,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>Cholinergic urticaria is a common disorder that has been associated with anaphylaxis. We report the events, workup, and eventual second dose vaccination of a patient at the Walter Reed National Military Medical Center, who had immediate anaphylaxis after administration of the first Pfizer-BioNTech Covid-19 (BNT162b2) vaccine dose. During the initial evaluation after anaphylaxis, the patient described a history of symptoms suspicious for cholinergic urticaria but had never had this condition confirmed with standardized testing. After the episode of anaphylaxis, we performed several studies including immediate hypersensitivity skin testing, which did not demonstrate vaccine or component sensitization. We then performed an exercise provocation challenge and confirmed the diagnosis of cholinergic urticaria. These results, combined with the patient history, suggested that the episode of anaphylaxis was most likely driven by a severe flare of cholinergic urticaria. After obtaining the patient\u2019s consent, she received and tolerated her second dose without any objective findings of anaphylaxis. We conclude that patients with mast cell disorders or anaphylaxis after their first Covid-19 immunization will benefit from referral to an allergist since receipt of their second Covid-19 immunization may be possible.<\/jats:p>","DOI":"10.1093\/milmed\/usab138","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T03:57:53Z","timestamp":1618545473000},"page":"e1556-e1558","source":"Crossref","is-referenced-by-count":15,"title":["Anaphylaxis After the Covid-19 Vaccine in a Patient With Cholinergic Urticaria"],"prefix":"10.1093","volume":"187","author":[{"given":"Hyun J","family":"Park","sequence":"first","affiliation":[{"name":"Department of Allergy and Immunology, Walter Reed National Military Medical Center , Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay R","family":"Montgomery","sequence":"additional","affiliation":[{"name":"Defense Health Agency Immunization Healthcare Division, Walter Reed National Military Medical Center , Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan A","family":"Boggs","sequence":"additional","affiliation":[{"name":"Department of Allergy and Immunology, Walter Reed National Military Medical Center , Bethesda, MD 20892, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,4,14]]},"reference":[{"issue":"50","key":"2022121510472475000_R1","doi-asserted-by":"crossref","first-page":"1922","DOI":"10.15585\/mmwr.mm6950e2","article-title":"The Advisory Committee on Immunization Practices\u2019 interim recommendation for use of Pfizer-BioNTech COVID-19 vaccine - United States, December 2020","volume":"69","author":"Oliver","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"5152","key":"2022121510472475000_R2","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.15585\/mmwr.mm695152e1","article-title":"The Advisory Committee on Immunization Practices\u2019 interim recommendation for use of Moderna COVID-19 vaccine - United States, December 2020","volume":"69","author":"Oliver","year":"2021","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"27","key":"2022121510472475000_R3","doi-asserted-by":"crossref","first-page":"2603","DOI":"10.1056\/NEJMoa2034577","article-title":"Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine","volume":"383","author":"Polack","year":"2020","journal-title":"N Engl J Med"},{"issue":"3","key":"2022121510472475000_R4","doi-asserted-by":"crossref","first-page":"868","DOI":"10.1016\/j.jaci.2015.07.048","article-title":"Risk of anaphylaxis after vaccination in children and adults","volume":"137","author":"McNeil","year":"2016","journal-title":"J Allergy Clin Immunol"},{"issue":"2","key":"2022121510472475000_R5","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.jaip.2015.09.021","article-title":"Cholinergic urticaria with anaphylaxis: an underrecognized clinical entity","volume":"4","author":"Vadas","year":"2016","journal-title":"J Allergy Clin Immunol Pract"},{"key":"2022121510472475000_R6","article-title":"mRNA vaccines to prevent COVID-19 disease and reported allergic reactions: current evidence and approach","author":"Banerji","year":"2020","journal-title":"J Allergy Clin Immunol Pract"},{"issue":"2","key":"2022121510472475000_R7","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.jdermsci.2014.04.007","article-title":"Development of a standardized pulse-controlled ergometry test for diagnosing and investigating cholinergic urticaria","volume":"75","author":"Altrichter","year":"2014","journal-title":"J Dermatol Sci"},{"issue":"5","key":"2022121510472475000_R8","doi-asserted-by":"crossref","first-page":"e80","DOI":"10.1016\/S1473-3099(20)30130-4","article-title":"The state of vaccine safety science: systematic reviews of the evidence","volume":"20","author":"Dudley","year":"2020","journal-title":"Lancet Infect Dis"},{"key":"2022121510472475000_R9","article-title":"What to do if you have an allergic reaction after getting a COVID-19 vaccine","author":"Centers for Disease Control and Prevention"}],"container-title":["Military Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/187\/Special%20Issue_13\/e1556\/47913813\/usab138.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/milmed\/article-pdf\/187\/Special%20Issue_13\/e1556\/47913813\/usab138.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T21:58:51Z","timestamp":1671141531000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/milmed\/article\/187\/Special%20Issue_13\/e1556\/6225467"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,14]]},"references-count":9,"journal-issue":{"issue":"Special Issue_13","published-online":{"date-parts":[[2021,4,14]]},"published-print":{"date-parts":[[2022,12,5]]}},"URL":"https:\/\/doi.org\/10.1093\/milmed\/usab138","relation":{},"ISSN":["0026-4075","1930-613X"],"issn-type":[{"value":"0026-4075","type":"print"},{"value":"1930-613X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,11,1]]},"published":{"date-parts":[[2021,4,14]]}}}