Does the COVID vaccine exacerbate asthma attacks?

Based on the paper titled “COVID vaccination and asthma exacerbation: might there be a link?”

Originally written by Colaneri et al. 2021

COVID-19 and asthma

Asthma is a lung condition characterised  by the narrowing of the tubes that carry air into the lungs, leading to difficulty in breathing. Due to the disease's nature, it has been suggested that COVID-19 infection may worsen asthma symptoms.

However, studies are yet to provide evidence to support this. COVID-19 causes an acute viral infection that could aggravate chronic lung-related diseases, including asthma¹. As a consequence, moderate-severe asthma is a risk factor for COVID-19 mortality.

Case study: COVID-19 vaccine and asthma

In response to this, Colaneri et al. 2021, carried out a case study to see if there is an increased risk of asthma exacerbation after obtaining the COVID-19 vaccine. This study was greatly relevant due to the high prevalence of teenagers and children with asthma who are to be vaccinated. The COVID-19 vaccine offers immeasurable benefits; however, it is vital to know the effects this vaccine has on asthma in order to provide both patients and physicians with the correct information in order to allow them to make informed decisions². 

The case study was based on a 28-year-old Caucasian female who completed the two-dose Pfizer mRNA-based vaccine (Pfizer-BioNTech) in February 2021. The female was not infected with COVID and had negative swab test results throughout the study period. She smoked occasionally and had a ten-year history of asthma.

None of her asthma exacerbation episodes required hospitalisation. In addition, she usually used an inhaler before exercising to provide complete relief.

The patient started experiencing a number of COVID-like symptoms ten hours after receiving the second dose of the Pfizer vaccine. These symptoms included dry cough, fever with a temperature of 39 degrees Celsius, and fatigue. According to the vaccine national surveillance systems, the symptoms decreased after five days, which was longer than expected³. 

In addition, about three weeks after receiving the second dose of  vaccine, the patient’s respiratory symptoms became aggravated. She started experiencing some difficulties in breathing while doing physical activities. She needed to start taking oral steroids and antihistamines to help with her worsening asthma episodes, especially during the night.

One month later, after her asthma had failed to come under control, she was referred to the unit of Allergology at the hospital where the study was taking place. After a physical examination, the patient was given a multi-drug regimen consisting of steroids and bronchodilators which are used to reduce inflammation and widen the airways in asthma patients.

In June 2021, the patient had suffered a more severe asthma attack which led to admission to the emergency department. At this stage, the patient could not breathe properly and was immediately given oxygen. She was sent to the pneumology unit, where she was treated with monoclonal antibodies that are used to fight infections.

In conclusion, there is relatively little data on the complex relationship between asthma and COVID-19. The case study has demonstrated the worsening of asthma effects following the Pfizer COVID-19 vaccine. However, the study only evaluated one patient and cannot be viewed as a reflection on how every patient with asthma will respond to receiving the COVID-19 vaccine.

The long-term effects of the coronavirus infection and the effects of the vaccine on asthma are an area that requires more exploration. This exploration is crucial due to the planned mass vaccination. Further studies on the comparison between other types of vaccines would be interesting to see if they would produce similar results.