International Journal of Clinical Case Reports, 2025, Vol.15, No.6, 271-282 http://medscipublisher.com/index.php/ijccr 272 factors that may trigger immune responses, especially excipients like polyethylene glycol (PEG) and sorbitol 80. Studies have shown that they are related to allergic reactions to some vaccines (Risma et al., 2021; Luxi et al., 2022; Paul et al., 2022). This study will explore the immune mechanism of anaphylactic shock after vaccination, summarize the current pathophysiological research basis on vaccine allergic reactions, including the clearly defined igE-mediated mechanism and the newly discovered non-igE-mediated mechanism. This article aims to clarify the related risk factors, symptoms, and key molecular action processes, and establish a corresponding risk assessment system. This study will also, in combination with research evidence, put forward suggestions for prevention, early identification and on-site handling at vaccination, such as screening for high-risk groups before vaccination, observation plans after vaccination, emergency training for medical staff, and desensitization methods for some patients. These contents can help medical staff and decision-makers better deal with the complex problems in modern vaccination work, consolidate public trust, and facilitate the smooth progress of vaccination work. 2 Incidence Rate and High-risk Groups 2.1 Approximate incidence rates of anaphylactic shock and common related vaccines after vaccination Anaphylactic shock that occurs after vaccination is a rare but highly harmful adverse reaction. For most vaccines, the probability of such reactions in children and adults is approximately 0.65 to 1.6 cases per million doses (Bohlke et al., 2003). Among influenza vaccines, especially the inactivated trivalent type, relatively more related cases have been reported in adults, with an occurrence probability of approximately 1.35 to 1.59 cases per million doses. However, for commonly used vaccines for children such as measles-mumps-rubella (MMR) and chickenpox, the observed occurrence probability may be slightly higher, with approximately 5.8 cases per million doses, but overall it is still extremely rare. Attention to mRNA COVID-19 vaccines has found that the probability of them causing anaphylactic shock is usually higher than that of traditional vaccines. Summary analysis shows that there are approximately 2.5 to 8 cases per one million doses of mRNA vaccines, while the occurrence probabilities of adenovirus vector vaccines and inactivated vaccines are slightly lower (Alhumaid et al., 2021; Luxi et al., 2022). Overall, however, the risk is still very low. Most cases are not fatal and can improve with timely treatment (Toledo-Salinas et al., 2022; Boufidou et al., 2023). For new vaccines such as the attenuated dengue vaccine, monitoring data show that the frequency of allergic reactions is approximately 63.1 per million doses. This also makes us more aware of how important it is to continuously do a good job in drug safety monitoring after the new vaccine is launched (Pembrorio et al., 2024). 2.2 High-risk groups: people with severe allergies, atopic constitutions or chronic diseases Although anaphylactic shock can occur in individuals without any history of allergies, those with a history of severe allergic reactions, asthma, and atopic diseases such as allergic rhinitis and eczema have a higher risk of allergic reactions after vaccination (Kounis et al., 2021). Large-scale analyses based on adverse event reporting systems and cohort studies have shown that being female, having a history of atopic diseases, and having chronic underlying diseases are all important risk factors. Compared with those without a history of allergies, the odds ratio of allergic reactions after vaccination in people with asthma or a history of allergies was approximately 1.6 to 7 (Alhumaid et al., 2021; Alhumaid et al., 2021; Bian et al., 2022). Despite this, the absolute risk remains low, and most individuals with a history of severe allergies do not experience adverse events after vaccination (Wentrys and Stopyra, 2022; Batac et al., 2025). Studies on high-risk groups (such as patients with mast cell diseases or hereditary angioedema) have also found that under close monitoring and appropriate protection, the COVID-19 vaccine is generally safe and well tolerated. However, such groups are usually more suitable for vaccination in an environment with the ability to manage severe allergic reactions. It is also possible to consider moderately extending the observation and pre-medication strategies (Kounis et al., 2021; Ieven et al., 2022; Luxi et al., 2022).
RkJQdWJsaXNoZXIy MjQ4ODYzNA==