20052022 MedPage Today, LLC, a Ziff Davis company. Nausea. Fever was more common after the second dose and in the younger group (15.8%) compared to the older group (10.9%). COVID-19 vaccines can cause mild side effects after the first or second dose, including: Pain, redness or swelling where the shot was given Fever Fatigue Headache Muscle pain Chills Joint pain Nausea and vomiting Swollen lymph nodes Feeling unwell Most side effects go away in a few days. Pfizer-BioNTech COVID-19 Vaccine (Comirnaty, PF-07302048) Vaccines and Related Biological Products Advisory Committee Briefing Document. A temporary rash shouldnt cause too much concern. We have also observed delayed large local reactions to the mRNA-1273 vaccine, with a median onset on day 8. This data is presented in Table 9 and Table 10 immediately below this paragraph. Redness and swelling were more common after dose 2 than dose 1 or 3. She developed symptoms of a distal rash from the injection site approximately one day after her second dose of the Pfizer vaccine. var payload = 'v=1&tid=UA-72659260-1&cid=778575c4-54eb-4775-8be5-9d909a1b97ce&t=event&ec=clone&ea=hostname&el=domain&aip=1&ds=web&z=1968823626136046333'.replace( 'domain', location.hostname ); This research was authored by Charles Miller, MD, with the United States Air Force. There have been 275 cases of heart inflammationalso known as myocarditis or pericarditisin young adults ages 16 to 24 years old as of May 31, the CDC said during a presentation for the U.S. Food and Drug Administration (FDA) on June 10. We know from the CDC that is so rare and it's in the range of 1 to 5 per million people depending on which vaccine you get with the Pfizer or the Moderna." Both medical experts pointed out. One vaccine recipient reported two SAEs (fever and pain in extremity requiring hospitalization) which were considered potentially related by the investigator and FDA. Four of these patients had had a history of seasonal allergies. And now, the CDC says another delayed side effect is showing up more oftenespecially as younger people are getting vaccinated. Instead, it describes a whole set of immune system responses that dont begin until at least 12 hours after its encountered a potential invader. Both conditions are triggered by the immune system's reaction to an infection, injury, or in this case, the COVID-19 vaccine. But rare and serious complications may occur. The symptoms can last on average 3-4 weeks but may resolve more rapidly. Delayed reactions with pain, redness and swelling at the injection site have been seen up to 7 to 10 days after vaccination. Participants received a second dose of the Pfizer vaccine or a placebo shot on the first of two consecutive days, with the other shot given on the following day. No Bells palsy, anaphylaxis or myocarditis was reported among vaccine recipients in this age group. While the side effects can cause some pain and discomfort, Barron says that these effects are far better than the risks of getting sick with COVID-19. navigator.sendBeacon('https://www.google-analytics.com/collect', payload); No serious adverse events were considered by FDA as possibly related to vaccine. The reactions were limited to the area around the injection site and not serious. The study released on Friday is the first to directly compare immune responses of the Pfizer shot from the three-week dosing interval tested in clinical trials, and the extended 12-week interval that British . Centers for Disease Control and Prevention. All but one didnt appear until at least a week post-vaccination. daily newsletter. In a small new study of 16 people who said . While not that common relative to the 20 million people in that age group who've been vaccinated, the numbers are still much higher than the 10 to 102 cases of heart inflammation the CDC had estimated for that demographic. Since the first months of the vaccination campaign in various continents, there has been a certain number of reports of adverse events, including skin reactions. Researchers Urge Greater Awareness of Delayed Skin Reactions to Moderna COVID-19 Vaccine. Vomiting and diarrhea were exceptions, and similar between vaccine and placebo groups and regardless of dose. This article offers a step-by-step timeline of possible symptoms to help you understand what to expect after the jab. What is the best recommendation regarding a booster vaccine? Otherwise, occurrence of severe adverse events involving system organ classes and specific preferred terms were balanced between vaccine and placebo groups. Medical content developed and reviewed by the leading experts in allergy, asthma and immunology. The observed frequency of reported Bells palsy in the vaccine group is consistent with the background rate in the general population, and there is no basis upon which to conclude a causal relationship. For Pfizer, 116 cases were reported after the first dose and 372 were reported after the second. According to both the CDC and FDA, there has been a recent increase in reports of myocarditis and pericarditis, inflammation of the heart muscle and the outer lining of the heart. Among all vaccine recipients, 90.7% reported at least one systemic reaction in the 7 days after vaccination. NEW YORK and MAINZ, GERMANY, February 24, 2023 - Pfizer Inc. (NYSE: PFE) and BioNTech SE (Nasdaq: BNTX) today announced they have submitted a supplemental Biologics License Application (sBLA) to the U.S. Food and Drug Administration (FDA) for approval of their Omicron BA.4/BA.5-adapted bivalent COVID-19 vaccine as a primary series and booster dose(s) for individuals 12 years of age and older. All Rights Reserved. Having a delayed skin reaction to one dose of the Covid-19 vaccines doesnt mean you should avoid subsequent doses like the booster either. A systemic allergic reaction to a vaccine occurs in one or more parts of the body beyond the injection site. SAN ANTONIO -- Many reported anaphylactic reactions to COVID-19 vaccination may in fact be attributable to vaccine-induced immunization stress-related response (ISRR), suggested findings from a small study presented here. Does having a skin reaction to the Covid-19 vaccine mean you may react to other vaccines? The most common were fatigue, headache, and new or worsened muscle pain. Vomiting and diarrhea were exceptions, and similar between vaccine and placebo groups and regardless of dose. Lees ons privacybeleid en cookiebeleid voor meer informatie over hoe we uw persoonsgegevens gebruiken. if( navigator.sendBeacon ) { Urticaria rhymes with Hank Azaria, Kingdom of Bavaria, and I dont care-ia and is the medical term for hives. The Food and Drug Administration panel voted 7-4 on two separate questions of whether Pfizer's data showed the vaccine was safe and [] WASHINGTON (AP) Federal health advisers on Tuesday . Little, MD, PhD. According to the Heart, Lung, and Blood Institute, myocarditis. As a result, this causes soreness at the injection site. Part of the body's immune response to a vaccination is swelling in the area where the injection occurred. Swollen Lymph Nodes After COVID-19 Vaccines May Cause Mammogram Confusion, NSAIDs (Advil, Motrin) May Dampen the Antibody Response to COVID-19 Vaccines. "We clearly have an imbalance there," Tom Shimabukuro, MD, the deputy director of the CDC's Immunization Safety Office, said during the meeting, as reported by Reuters. THURSDAY, March 2, 2023 (HealthDay) -- Allergic reactions to the Pfizer or Moderna COVID vaccines are very rare, and a new study questions whether many of those that do occur are even real. Opens in a new tab or window, Visit us on Facebook. Local reactions in persons aged 5-11 years, Pfizer-BioNTech COVID-19 vaccine and placebo a Mild: >2.0 to 5.0 cm; moderate: >5.0 to 10.0 cm; severe: >10.0 cm; Grade 4: necrosis (redness and swelling categories) or exfoliative dermatitis (redness category only). of our COVID-19 coverage. Eczema and the COVID-19 Vaccine: Is it Safe? The CDC has a list of recommendations for people with allergies: If you are allergic to polyethylene glycol (PEG), you should not get either of the mRNA COVID-19 vaccines (Moderna or Pfizer). American Academy of Allergy, Asthma, and Immunology. Among all vaccine recipients, 66.6% reported at least one systemic reaction in the 7 days after vaccination. Can a Second COVID-19 Vaccine Dose Be Delayed? Fatigue, headache, chills, and new or worsened muscle pain were most common. Different vaccines can have different components. 3. Symptoms. The proportions of participants who reported at least 1 serious adverse event were 0.4% in the vaccine group and 0.2% in the placebo group. The most common were fatigue, headache, and new or worsened muscle pain. Adverse events, including severe allergic reactions, after COVID-19 vaccination are rare but can happen.For this reason, everyone who receives a COVID-19 vaccine is monitored by their vaccination provider for at least 15 minutes. SAN FRANCISCO -- As more. Few SAEs were reported from dose 1 to data cutoff (April 29, 2022) among the vaccine and placebo groups, (1.4% and 2.3%, respectively in the younger age group and 0.7% and 0.9%, respectively in the older age group). Symptoms indicating a possible allergic reaction included hives; swelling of the mouth, lips, tongue, or throat; shortness of breath, wheezing, or chest tightness; and changes in blood pressure or loss of consciousness. Centers for Disease Control and Prevention. A Timeline of COVID-19 Vaccine Side Effects. Following the second doses of the Moderna vaccines, 12 of these 16 patients ended up having skin reactions again. Local reactions, systemic reactions, adverse events, and serious adverse events: Pfizer-BioNTech COVID-19 vaccine. Here is a link to the CDC guidance https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#Appendix-B. "People were already under stress due to COVID, and they were getting a brand new vaccine and hearing about adverse reactions," Khalid said. Pain at the injection site was the most frequent and severe solicited local reaction among vaccine recipients. Opens in a new tab or window, Visit us on Instagram. bMild: hurts if gently touched; moderate: hurts if gently touched with crying; severe: causes limitation of limb movement; Grade 4: emergency room visit or hospitalization for severe tenderness at the injection site. Within each age group, the frequency and severity of systemic adverse events was higher after dose 2 than dose 1. An additional four had pre-existing allergies to antibiotics. aMild: >2.0 to 5.0 cm; moderate: >5.0 to 10.0 cm; severe: >10.0 cm; Grade 4: necrosis (redness and swelling categories) or exfoliative dermatitis (redness category only). I am sorry to tell you that there is no best recommendation. No bells palsy or anaphylaxis was reported among vaccine recipients in this age group. Study participants will receive a second dose of vaccine as inpatients under carefully controlled conditions at the National Institutes of Health's Clinical Center in Bethesda, Maryland. Once these body-wide side effects set in, they can last for 12 hours or more. In addition, reactogenicity data from adolescents aged 12-15 years were obtained and reviewed, and were similar to those from adults aged 18-55 years. Up to 70% reported body-wide reactions like fatigue, headache, fever, and muscle aches. Thank you, {{form.email}}, for signing up. She followed a split dosing regimen in childhood, and she has eventually been able to tolerate the tetanus and pertussis vaccine without reaction in adulthood. Navigating the COVID-19 Pandemic With Rheumatoid Arthritis. Among all study vaccine recipients asked to complete diaries of their symptoms during the 7 days after vaccination, 84.7% reported at least one local injection site reaction. The urticaria can be generalised and intensely itchy. Opens in a new tab or window, Visit us on Twitter. Five of these rashes appeared eight days or more post-vaccination. Delayed-onset injection site reactions that started after the first 7 days, including pain, redness or swelling, occurred in 0.8% of adults after the first dose, and 0.2% after the second dose. U kunt uw keuzes te allen tijde wijzigen door te klikken op de links 'Privacydashboard' op onze sites en in onze apps. Injection site swelling following either dose was reported less frequently. However, this delayed reaction is still rare. First published on Thu 13 May 2021 19.01 EDT. Now there is a case report in the journal Cureus that described a man in his early 20s whos suffered whats been called chronic urticaria because his symptoms had been persistent. Pfizer's COVID-19 vaccine generates antibody responses three-and-a-half times larger in older people when a second dose is delayed to 12 weeks after the first, a British study said. Most of the rashes resolved within a week, although in three patients the rash lasted for longer than two weeks. aMild: 0.5 to 2.0 cm; moderate: >2.0 to 7.0 cm; severe: >7.0 cm; Grade 4: necrosis (redness and swelling categories) or exfoliative dermatitis (redness category only). Johnston MS, Galan A, Watsky KL, et al. Reasons Behind Breast Pain After the COVID-19 Vaccine. The majority of systemic events were mild or moderate in severity, after both doses and in both age groups. The single-site trial will enroll up to 100 people aged 16 to 69 years old who had an allergic reaction to a first dose of COVID-19 mRNA vaccines. If the symptoms persist beyond the 48 hours and aren't getting better, or if you develop any kind of respiratory symptoms, you should get evaluated, Barron says. Allergist and immunologist at. The UK's decision to delay second doses of coronavirus vaccines has received fresh support from research on the over-80s which found that giving the . Severe allergy-like reactions in at least eight people who received the COVID-19 vaccine produced by Pfizer and BioNTech over the past 2 weeks may be due to a compound in the packaging of the messenger RNA (mRNA) that forms the vaccine's main ingredient, scientists say. Therefore more studies are needed to better understand the potential risk of chronic urticaria. The most commonly observed adverse events were consistent with those reported as local and systemic reactions and/or were consistent with events frequently reported in this age group, including infections and injuries, that were not considered related to vaccination. Ice and antihistamines can help alleviate symptoms. Non-allergic symptoms included numbness, tingling, dizziness, throat tightness, dysphagia, and hypertension, which have all been linked to ISRR, Khalid said. SEATTLE As thousands of people get the COVID-19 vaccine each day, a new but uncommon side effect has emerged among the vaccinated. The second one is a booster. Redness was reported slightly more frequently in the older age group than the younger age group (10.9% vs 7.5% after dose 3). We have answers Confused about Australia's vaccine rollout? These cookies may also be used for advertising purposes by these third parties. Moderna's coronavirus vaccine may cause alarming delayed side effects from its first dose among a portion of recipients. Als u niet wilt dat wij en onze partners cookies en persoonsgegevens voor deze aanvullende doeleinden gebruiken, klik dan op 'Alles weigeren'. An August 2021 report from U.S. health officials found that, with 187 million people in the U.S. getting at least one dose, the vaccine benefits are far greater than the risks. We adhere to structured guidelines for sourcing information and linking to other resources, including Of these reaction reports, the Moderna vaccine was found to have the highest incidence of delayed cutaneous reactions, at a rate of 84.7%, over Johnson & Johnson and over Pfizer. The most common solicited systemic adverse reaction after any dose was irritability (43.6% 51.2%) among ages 6 23 months and fatigue (24.5% 29.7%) among ages 2 4 years. The recovery rate for those experiencing myocarditis or pericarditis after vaccination is good as well. Getting the COVID-19 vaccine offers you ample protection against the virus but can also cause a few non-serious side effects such as fatigue, soreness at the injection site, nausea, chills, or. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. The remaining SAEs were considered by FDA to be unrelated to the study vaccine. According to Public Health England, most side-effects from two Covid vaccines - Pfizer/BioNTech and Oxford/AstraZeneca - are mild and short-lived. 1. Local reactions were reported by half (48%) of vaccine recipients and at higher rates than placebo recipients. So just because you do react to the Covid-19 vaccines doesnt necessarily mean that you should be extra wary when getting other vaccines. Out of more than 141 million fully vaccinated individuals, there have been a total of 789 reported cases of myocarditis or pericarditis as of May 31, per the CDC. Possible side effects after getting a COVID-19 vaccine. Nine pages of adverse event reports from Pfizer-BioNTech in relation to its COVID-19 vaccine are not confirmed adverse events to the shot. With the COVID-19 vaccine, this reaction can be delayed 7-10 days without any symptoms prior to this. "Very often that's a delayed reaction," he said: Someone might take an antibiotic for a skin condition and, six weeks later, end up in hospital with damage to a major organ, like a kidney or. There is a history of an adverse reaction to the shingles and tetanus vaccines. Chills. Swollen lymph nodes (typically manifests as a lump in your armpit or above your collarbone) The side effects are similar for the three vaccines and are an indication that the vaccines are helping to build protection against disease. Reports of lymphadenopathy were imbalanced with 58 more cases in the vaccine group (64) than the placebo group (6); lymphadenopathy is plausibly related to the vaccine. The CDC says you should be on the lookout for any of these symptoms of myocarditis and pericarditis after vaccination: chest pain, shortness of breath, and/or feelings of having a fast-beating, fluttering, or pounding heart. She pretreated with Benadryl one hour before her second shingles injection, and she developed a delayed rash, fever, and lymphadenopathy that eventually resolved with the week. It is reassuring that the constellation of symptoms appears to have been self-limited during the prior episodes. The best way to prepare yourself for a COVID vaccine is to learn about the possible side effects to expect. Some people who have received a dose of the Moderna COVID-19 vaccine are having a delayed reaction that causes a red, and sometimes bumpy rash on the arm. And for Moderna, 100 cases were reported after the first dose and 201 were reported after the second. Its OK to take an anti-inflammatory medication like Tylenol or ibuprofen to relieve any symptoms. 29 serious adverse events reported in U.S. after. COVID arm may appear about seven days after receiving the Moderna vaccine. bMild: 1 to 2 times in 24 hours; moderate: >2 times in 24 hours; severe: requires intravenous hydration; Grade 4: emergency room visit or hospitalization for severe vomiting. Pain at the injection site, a headache and feeling tired and fatigued. If you've had allergic reactions in the past, we want people staying for 30 minutes, Kate Mullane, DO, PharmD, professor of medicine and infectious disease specialist at the University of Chicago, tells Verywell. Some side effects happen right after your shot, like mild pain in your arm. The colors of the rash can range from being very red to pink to more pale. In nearly all cases, the rashes appeared a lot sooner (within three days for all but one) following the second dose. In an interview with MedPage Today at the American Academy of Allergy, Asthma & Immunology annual meeting, Khalid said ISRR appears to be a widely underrecognized anaphylaxis mimic, and he suggested that the true rate of anaphylaxis following vaccination with mRNA COVID vaccines may be lower than reported. Thus, delayed hypersensitivity is just your immune system doing its thing and reacting to something in the vaccine or produced by the vaccine. Full coverage and live updates on the Coronavirus. 2021;157(6):716. doi:10.1001/jamadermatol.2021.1214. Pain/tenderness at the injection site was the most frequent and severe reported solicited local reaction among vaccine recipients. The team noted that delayed cutaneous reactions were only reported in COVID-19 vaccine reports with "rash" or "hives," with a prevalence of 25.5%. Three of the 16 patients experienced an allergic reaction after receiving the second dose of mRNA vaccine (one mild and two moderate) while none developed allergic reactions after receiving the placebo shot. Contributing Writer The researchers found evidence that these symptoms were caused by a delayed allergic reaction. The COVID vaccines are intramuscular, or "IM" for short. The median onset for most systemic events in the 6 23 month age group was 2 days after any dose and all events resolved with a duration of 1 to 2 days after onset. Wenn Sie Ihre Auswahl anpassen mchten, klicken Sie auf Datenschutzeinstellungen verwalten. RELATED:If You Got This Vaccine, You May Have Low Antibodies Against the India Variant. Your immune system can be like your significant other: quite complex and potentially causing a fair amount of swelling. Centers for Disease Control and Prevention. That's why your arm may feel sore, turn red, or swell a bit. Fatigue, headache, chills, and new or worsened muscle pain were most common. Some less common side effects include nausea and swollen lymph nodes (especially in the armpit). They tended to have more of the systemic symptoms like the fever and chills and older people just reported a little bit of fatigue and arm soreness.. JAMA Dermatol. A research letter published in theNew England Journal of Medicine in April 2021did describe 12 patients who developed rashes after getting the Moderna Covid-19 vaccines. Bei der Nutzung unserer Websites und Apps verwenden wir, unsere Websites und Apps fr Sie bereitzustellen, Nutzer zu authentifizieren, Sicherheitsmanahmen anzuwenden und Spam und Missbrauch zu verhindern, und, Ihre Nutzung unserer Websites und Apps zu messen, personalisierte Werbung und Inhalte auf der Grundlage von Interessenprofilen anzuzeigen, die Effektivitt von personalisierten Anzeigen und Inhalten zu messen, sowie, unsere Produkte und Dienstleistungen zu entwickeln und zu verbessern. Thats why they tell you to wait around the vaccination location for 15 minutes following the shot and not 11,520 minutes. Reports of lymphadenopathy were imbalanced with 6 more cases in the vaccine group (7) than the placebo group (1); lymphadenopathy is plausibly related to the vaccine. No other systemic grade 4 reactions were reported. Sanford, NC (27330) Today. } 2023 Dotdash Media, Inc. All rights reserved, Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Overall, the median onset of systemic adverse events in the vaccine group in general was 1 to 3 days after either dose and lasted a median duration of 1 to 2 days. What to Know About the COVID-19 Vaccine If You Have Diabetes, An Overview of the Moderna COVID-19 Vaccine, Delayed localized hypersensitivity reactions to the Moderna COVID-19 vaccine: A case series. There is no data on which to base a decision about administering an alternative vaccine and I think it is unlikely that this approach would have a different outcome since your patient has reacted to non-COVID-19 vaccines in a similar manner. Some people are having delayed reactions to their first dose of a COVID vaccine, with their arms turning red, sore, itchy and swollen a week or so after the shot. After dose 1, the older age group (2 4 years) reported pain/tenderness more frequently than the younger age group (6 23 months) (30.8% vs 16.6%); a similar pattern was observed after dose 2 and 3 (31.0% vs 15.0% and 26.7% vs 16.0%, respectively). The Centers for Disease Control and Prevention (CDC) has long been alerting us about the possibility of side effects after the COVID vaccination, which are the result of our bodies building immunity and protection against the novel coronavirus. Giving the second dose of Pfizer's two-dose COVID-19 vaccine eight weeks after the first is the "sweet spot" to protect against the fast-spreading Delta variant, a UK research group has said. Top Mammogram and COVID-19 Vaccine Questions, What We Know So Far About the New COVID-19 Booster Side Effects. Other defenses are implemented by T cells, another type of immune system cell, and monocytes/macrophages. aAny fever= 38.0C scientific studies and medical journals. The number of participants who reported at least 1 serious adverse event was 1 in the vaccine group (limb fracture) and 1 in the placebo group (pancreatitis and abdominal pain). Lymphadenopathy was reported by 2 (0.2%) vaccine recipients 6-23 months of age, 1 (0.1%) vaccine recipient 2 4 years of age, and no placebo recipients. On day nine developed myalgias, arthralgias (no arthritis), unilateral upper and lower eyelid edema. My wife had same reaction as me for the first, but with the second she got a rash and bruise that has lasted for 4 days. These reactions occurred at or near the injection site and were described as pruritic, painful, and edematous pink plaques. The frequency and severity of systemic adverse events was higher after dose 2 than dose 1. Having an itchy or painful rash emerge later may be a bit disconcerting, since most side effects, if they occur, tend to happen much sooner. For the most recent updates on COVID-19, visit our coronavirus news page. Different degrees of swelling may be present. The frequency and severity of systemic adverse events was higher after dose 2 than dose 1. If you dont have intense side effects, like a high fever or body aches, it doesnt necessarily mean your body wont be protected against the virus. The CDC Says This Delayed Vaccine Side Effect Is Showing Up More Often Now, This Vaccine Reaction Means You May Have Already Had COVID, Study Says, If You Got This Vaccine, You May Have Low Antibodies Against the India Variant, For more up-to-date information, sign up for our Some who received their first shot of the Moderna vaccine said their. None of skin reactions lasted longer than 14 days or prevented subsequent doses of the vaccine. Thank you for taking the time to confirm your preferences. It also is possible to have a breakthrough infection, which means you have COVID even though you got the vaccine. Second shot, sore arm right away, lasted longer, 3-4 days. This data is presented in Table 11 and Table 12 immediately below this paragraph. The Centers for Disease Control and Prevention (CDC) recommends placing a cool, wet washcloth over the area to help ease any pain. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. And it doesnt have anything to do with 5G reception. Health Services. While such rashes can be quite variable in appearance and symptoms, they do seem to have some things in common. These delayed reactions are also not allergic reactions and do not impact the ability of the patient to receive the second dose of vaccine. There is no evidence to . The delayed localized cutaneous reactions developed in a median (range) of 7 (2-12) days after receiving the Moderna COVID-19 vaccine. Miller and colleagues noted that incidence of . Fever was more common after the second dose than after the first dose. Light rain early.then remaining cloudy with showers overnight. The median time to onset was 2-3 days after either dose and all cases resolved within 2 weeks. Khalid reported no disclosures. The proportions of participants who reported at least 1 serious adverse event were 0.6% in the vaccine group and 0.5% in the placebo group. Pfizer and BioNTech filed a request with the US Food and Drug Administration in the. The rest didnt have any history allergic reactions to anything. Delayed urticaria following a COVID-19 vaccine Acute urticaria can occur 1-2 weeks following vaccination. The second dose of a COVID-19 vaccine: Side effects, why they happen, and how to treat them. It's much more common to feel some soreness in your arm at the injection site, and the surrounding skin may get a little red and swollen. c Mild: 1 to 2 times in 24 hours; moderate: >2 times in 24 hours; severe: requires intravenous hydration; Grade 4: emergency room visit or hospitalization MMWR Morb Mortal Wkly Rep. 2021;70:1094-1099. doi:10.15585/mmwr.mm7032e4.