How to deal with adverse reactions of novel coronavirus vaccine? Here comes the authoritative answer

Click the blue word “medicine Liaozhai” above to pay attention easily! Timely and effective disposal of adverse events and adverse reactions of novel coronavirus vaccination can enhance the recognition of vaccination in the whole society, reduce the hesitation of vaccination, increase the voluntary vaccination rate, accelerate the establishment of the colony’s immune barrier against COVID-19, and reduce the risk of bounce and outbreak of epidemic situation.

How to do the job well, experts gave the latest expert consensus on New Coronavirus inactivated vaccine inoculation (2021 Edition).

  1.

General adverse reactions and most adverse reactions reported after vaccination with COVID-19 vaccine were mild or moderate.

A few of the vaccinated persons had a total body reaction lasting more than 7d.

  The most common systemic adverse reactions are: fever, nausea, vomiting, headache, chest tightness, dizziness, muscle soreness, cough, sore throat, runny nose, fatigue, anorexia and diarrhea.

The symptoms are mild and self limiting.

They are dose-related and most of them occur after the first vaccination.

They can be treated symptomatically, but these reactions generally do not affect patients to vaccinate the same vaccine again.

  2、 Abnormal adverse reactions and treatment 01 adverse reactions of skin system (1) local reactions: erythema, pain, swelling, induration and pruritus may appear at the vaccine injection site, and these symptoms may begin to appear several hours or even the second day after injection.

These local symptoms are mild and self limiting.

Generally, they do not need special treatment and can be observed.

If the pain is severe, local cold compress or oral painkillers can be used.

If itching, oral anti allergic drugs can be taken.

  (2) Allergy: rapid type hypersensitivity is rare.

The rapid type hypersensitivity reaction of the confirmed vaccine is usually related to excipients or inactive ingredients, which usually occurs several minutes to one hour after vaccination.

Therefore, it must be observed for 30 minutes after vaccination.

  Occasionally, some patients develop a small amount of urticaria or mild angioedema a few hours or days after vaccination, which is generally a normal immune response to immunization and does not need additional evaluation and treatment.

  After vaccination with the novel coronavirus virus, 10d should also observe the presence of viral herpes and other unusual skin rashes.

In case of abnormal rash, go to the dermatology clinic for treatment in time.

  02 the digestive system adverse reactions have been reported in the literature.

The common reactions of the digestive system after inoculation of COVID-19 vaccine include nausea, diarrhea, nausea and vomiting.

Abdominal pain is rare.

The incidence of anorexia is 5% ~ 22%, diarrhea is 8% ~ 11%, nausea is 8% ~ 13%, vomiting is 1% ~ 2%, and abdominal pain is rare.

  Most gastrointestinal symptoms are mild, mostly within 24 hours after inoculation, rarely more than 48 hours.

They can generally be relieved by themselves.

If diarrhea and vomiting are serious, they can be treated with rehydration and electrolyte supplement.

  03 nervous system adverse reactions (1) convulsion and epilepsy: after COVID-19 vaccination, convulsions or epilepsy can occur in children.

Convulsions often occur in the form of febrile convulsions.

Generally, the prognosis is good and there are few sequelae.

  The duration of convulsion or epilepsy is generally 1 ~ 3min, so there is no need to rush to use anticonvulsant drugs.

For cases with status epilepticus (> 30min), rapid intravenous medication is needed to stop convulsion, and further find and deal with the causes of fever and convulsion.

  (2) Immune demyelinating disease of the central nervous system: because the vaccine specific antigen invades the central nervous system, it changes the antigenicity of the central nervous system, resulting in a series of abnormal immune reactions in the central nervous system.

  The main clinical manifestations are the symptoms and signs of diffuse damage to the brain and spinal cord, mainly including acute disseminated encephalomyelitis, cerebellar ataxia, multiple sclerosis or neuromyelitis spectrum diseases.

  The treatment principle is mainly glucocorticoid or immunoglobulin, dehydration and intracranial pressure reduction.

  (3) Immune demyelinating lesions of the peripheral nervous system: including acute inflammatory demyelinating polyneuropathy (AIDP), optic neuritis, facial neuritis and other diseases.

  AIDP is characterized by symmetrical flaccid paralysis of limbs.

The course of disease is self limited, and most of them will recover completely within a few weeks to months.

However, severe cases can die of respiratory muscle paralysis in the acute stage.

The treatment principle is mainly comprehensive symptomatic treatment such as glucocorticoid or immunoglobulin and nutritional nerve.

   04 there were reports of adverse respiratory reactions in the respiratory system.

There were cough, dyspnea, and acute allergy related bronchospasm after vaccination of COVID-19 inactivated vaccine.

The incidence of cough was 3.1%~3.6%, and the incidence of dyspnea was 1.1%~1.4%.

Those with severe cough symptoms can be treated with antitussive drugs.

  Acute bronchospasm can occur alone or in combination with anaphylactic shock.

The main manifestations of patients are chest tightness, dyspnea and wheezing.

Some patients can have cough and chest pain.

See the emergency treatment of serious adverse reactions.

At the same time, bronchodilators can be given (short acting drugs are preferred) β Inhalation of 2 receptor agonists such as salbutamol.

  05 hematological adverse reaction (1) vaccine secondary immune thrombocytopenia: this complication mainly occurs in the early stage (1 ~ 14 days) after vaccination, and mostly after the first dose of vaccine.

It is distributed in all age groups and has no sex difference.

The clinical symptoms are only thrombocytopenia without thrombosis, such as skin ecchymosis, epistaxis, vaginal bleeding, etc.

intracranial hemorrhage can be found in severe cases.

  Possible effective treatment measures include immunosuppressive therapy, platelet raising therapy and platelet transfusion.

Plasma exchange and other treatments such as rituximab can be considered in severe cases.

  (2) vaccine induced immune thrombotic thrombocytopenia (VITT):VITT is a rare complication associated with COVID-19 vaccine.

According to available information, the incidence of VITT is 100 thousand 0.8~3.

At present, all the reported Vitt occurred in adenovirus vector vaccine, and there was no report of inactivated vaccine.

  The mechanism of Vitt is not clear.

The clinical manifestations are highly similar to heparin induced thrombocytopenia.

The disease progresses rapidly and the mortality is high (33% ~ 54%).

For patients with highly suspected or confirmed Vitt, treatment should be started as soon as possible.

The treatment principle is similar to that of thrombocytopenia.

  Adverse cardiovascular reactions (1) tachycardia: sinus tachycardia occurred in some patients, and ventricular tachycardia was reported in other cases.

The occurrence of sinus tachycardia, after excluding allergy and other reasons, is mostly related to the pain and tension of the injection part.

If the symptoms are not serious, they can be observed and generally can improve by themselves; If the patient has severe symptoms, it can be given β Receptor blocker therapy.

  If it is ventricular tachycardia, the person with unstable vital signs shall be directly electrocuted.

If the vital signs are stable, the patient shall be directly referred to the emergency department of a hospital with treatment ability by ambulance.

  (2) syncope: syncope has been reported in the clinical trials and practice of COVID-19 vaccine.

After the patient falls to the ground, it is necessary to urgently judge whether the patient is cardiac arrest according to the patient’s consciousness and the pulse of the great artery.

If it is cardiac arrest, it shall be treated according to cardiopulmonary resuscitation.

If it is syncope, it is mostly vasovagal syncope.

At this time, let the patient lie flat and turn his head to one side to avoid accidental inhalation.

The patient can recover after a few minutes.

  During the waiting period, blood pressure, heart rate and blood glucose were measured, and ECG was performed to see whether there were signs such as myocardial infarction, pulmonary embolism and malignant arrhythmia.

When the patient was conscious, he went to the hospital to find the cause of syncope..