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\begin{document}

\title{Risk factors of immunisation stress-related response to COVID-19
vaccination and history of allergy as a newly identified risk factor}



\author[1]{Tomonori Takano}%
\author[1]{Masanori Hirose}%
\author[1]{Yukitaka Yamasaki}%
\author[1]{Masatoshi Hara}%
\author[1]{Tomoyuki Okada}%
\author[1]{Hiroyuki Kunishima}%
\affil[1]{St Marianna University School of Medicine}%


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  \date{June 09, 2024}


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\begin{abstract}
Abstract Background Safe vaccination worldwide is critical for
eliminating the COVID-19 pandemic elimination. We aimed to evaluate
adverse reactions to vaccination using a web-based questionnaire and to
examine the risk factors for the occurrence of immunisation
stress-related response (ISRR). Methods We conducted a questionnaire
survey using Google Form\selectlanguage{ngerman}® among employees of St. Marianna University
Hospital who had received the COVID-19 vaccine between April 2021 and
May 2021, 1 week after the first and second vaccinations. We developed
and used a questionnaire to identify individuals with ISRR, according to
the World Health Organization diagnostic criteria. A generalised linear
mixed model was constructed with ISRR onset as the dependent variable,
subjects as the random factor, and each parameter as a fixed factor. A
multivariate model was constructed using the forced imputation method
with factors that were significant in the univariate analysis. Results
We enrolled 2,073 and 1,856 respondents in the first and second
questionnaire surveys, respectively. Fifty-five and 33 ISRR cases were
identified in the first and second vaccinations, respectively. In the
univariate analysis, strong pre-vaccination anxiety (odds ratio
{[}OR{]}, 2.3; 95\% confidence interval {[}CI{]}, 1.30--4.12, p=0·004)
and history of allergy (OR, 1.6; 95\% CI, 1.14--2.24, p=0·007) were
significant risk factors. Multivariate analysis also showed that strong
pre-vaccination anxiety (OR, 2.1; 95\% CI, 1.15--3.80, p=0.016) and
history of allergy (OR, 1.5; 95\% CI, 1.09--2.15, p=0.014) were
significant risk factors. Conclusions Confirmation of allergy prior to
vaccination and subsequent action are essential for addressing ISRR.%
\end{abstract}\selectlanguage{ngerman}%



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