Pennisi F, D’Amelio AC, Cuciniello R, Borlini S, Mirzaian L, Ricciardi GE, Minerva M, Gianfredi V, Signorelli C. Vaccines. 2025; 13(1):37. https://doi.org/10.3390/vaccines13010037Abstract
Background/Objectives: Vaccines have been recognized as one of the most effective public health interventions. However, vaccine-associated anaphylaxis, although rare, is a serious adverse reaction. The incidence of anaphylaxis related to non-COVID-19 vaccines in adults remains underreported. This systematic review and meta-analysis aim to estimate the incidence of post-vaccination anaphylaxis across various vaccines in adults.
Methods: A comprehensive literature search of PubMed, Embase, Scopus, and Web of Science identified studies on anaphylaxis following vaccination in adults (≥18 years), excluding COVID-19 vaccines. PRISMA 2020 guidelines were followed. The protocol was registered in PROSPERO in advance (ID CRD42024566928). Random-effects and fixed-effects models were used to pool data and estimate the logit proportion, with the logit-transformed proportion serving as the effect size, thereby allowing for the calculation of event rates.
 |
Forest plot of the random-effects model assessing the logit proportion among vulnerable populations (individuals with pre-existing allergies or chronic conditions).In the forest plot, the effect sizes of individual studies are represented in blue, while the overall effect size is shown in green. |
Results: A total of 37 studies were included in the systematic review, with 22 studies contributing to the meta-analysis, representing a combined population of 206,855,261 participants. Most studies focused on influenza vaccines (n = 15). Across all studies, 262 anaphylactic cases were reported, with 153 cases related to influenza vaccines, followed by herpes zoster virus vaccines (38 cases) and yellow fever vaccines (29 cases).