An Update in COVID-19 Vaccine Reactions in 2023: Progress and Understanding

Kimberly G. Blumenthal*, Matthew Greenhawt, Elizabeth J. Phillips, Nancy Agmon-Levin, David B.K. Golden, Marcus Shaker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


It has been 3 years since the coronavirus disease 2019 (COVID-19) pandemic was initially declared, and 2 years have passed since the first COVID-19 vaccines were introduced. Since then, 13.2 billion COVID-19 vaccine doses have been administered worldwide, largely with multiple doses of messenger RNA vaccines. Although mild local and systemic adverse effects after COVID-19 vaccination are common, serious adverse effects following immunization are rare, particularly when compared with the large number of vaccine doses administered. Immediate and delayed reactions are relatively common and present similarly to allergic and hypersensitivity reactions. Despite this, reactions generally do not commonly recur, cause sequelae, or contraindicate revaccination. In this Clinical Management Review, we provide an updated perspective of COVID-19 vaccine reactions, their spectrum and epidemiology, and recommended approaches to evaluation and management.

Original languageEnglish
Pages (from-to)3305-3318
Number of pages14
JournalJournal of Allergy and Clinical Immunology: In Practice
Issue number11
StatePublished - Nov 2023


  • Allergic reaction
  • COVID-19
  • Hives
  • Skin
  • Vaccine
  • Vaccine reaction
  • mRNA vaccine


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