International Journal of Clinical Case Reports, 2025, Vol.15, No.6, 271-282 http://medscipublisher.com/index.php/ijccr 276 Figure 2 Vaccine compound allergens (Adopted from Kounis et al., 2021) 5.2 Symptoms of the skin, respiratory and circulatory systems are key clues for early identification Early identification of anaphylactic shock depends on the grasp of key clues in the skin, respiratory and circulatory systems. Among them, skin signs (generalized urticaria, erythema, pruritus, angioedema) are the most common and often occur in the early stage of the disease (Hong and Sardinas, 2022; Paul et al., 2022; Pennisi et al., 2025). Respiratory symptoms such as tight throat, wheezing or wheezing, breathing difficulties and coughing indicate airway involvement. If not treated promptly, they can rapidly progress to respiratory failure. Circulatory system manifestations include hypotension, tachycardia, syncope and rare hypertensive responses, reflecting systemic vascular involvement and being crucial for determining whether shock has entered the stage (Furuto et al., 2022). Simultaneous involvement of two or more organ systems, such as skin combined with respiratory involvement, or skin combined with cardiovascular involvement, strongly supports the diagnosis of allergic reactions (Hong and Sardinas, 2022; Paul et al., 2022; Pennisi et al., 2025). It should be noted that up to 10-20% of cases may have no skin manifestations, especially in severe or rapidly progressive allergic reactions. Therefore, respiratory and circulatory signs must be vigilant, and it should be remembered that intramuscular injection of epinephrine is the cornerstone of treatment. All medical staff involved in vaccination should receive training. Be able to identify these early warning signals and immediately initiate emergency management (Kounis et al., 2021; Itekin et al., 2025; Pennisi et al., 2025). 5.3 Differentiation from shock types such as vasovagal syncope and anxiety response Being able to distinguish anaphylactic shock from other acute conditions after vaccination (such as vasovagal syncope and anxiety reactions) is the key to correct handling. Vasovagal syncope is often manifested as transient fainting, bradycardia, pale complexion, and decreased blood pressure. It is usually caused by emotional tension or pain and will recover quickly after lying down (Hong and Sardinas, 2022). Allergic reactions are more likely to present with accelerated heart rate, persistently low blood pressure, typical skin symptoms and difficulty breathing, which cannot be relieved by simply changing positions Anxiety responses may present with symptoms such as shortness of breath, dizziness or palpitations, but not like true anaphylactic shock where multiple systems are affected and the condition worsens rapidly. Other types of shock (such as infectious and cardiogenic shock) usually have a slower onset and are related to different medical conditions and underlying diseases. Adopting the standard diagnostic methods proposed by the World Allergy Organization or the Brighton Collaboration, the focus is on acute attacks, multiple organ impacts, and responses to adrenaline. It can help distinguish these easily confused situations (Hong and Sardinas, 2022; Pennisi et al., 2025), thereby using the correct first aid methods in the shortest time to prevent unnecessary treatment or delayed treatment. 6 Risk Assessment and Prevention before Vaccination 6.1 Carefully inquire about the history of allergies and underlying diseases, and conduct risk stratification Before getting vaccinated, a comprehensive assessment should be conducted. First, carefully inquire about the
RkJQdWJsaXNoZXIy MjQ4ODYzNA==