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Those Who Give the COVID-19 Vaccine Need to Be Trained to Use an EpiPen

Now that vaccines protecting people from the corona virus have arrived, the danger of dangerous attacks of anaphylaxis have arrived as well. Proper administration of epinephrine is now almost as important as using the vaccine itself. Our association fully supports comprehensive training on how to use an epinephrine auto-injector (EAI) device in an anaphylaxis emergency.

Those Who Give the COVID-19 Vaccine Need to Be Trained to Use an EpiPen

Nurse Receiving Covid-19 Vaccine Dec 2020
(AP Photo/Mark Lennihan, Pool) AP

By Robert K. Houton

The COVID-19 vaccination that began rolling out this week to frontline medical workers will hopefully end our long nightmare with this virus and the pandemic. But there is one concern: 1.6% of the American population, or roughly 5 million people, have experienced a severe allergic attack, called anaphylaxis, and may have a severe reaction to the vaccine.

As a result, all sites that are injecting the Pfizer-BioNTech COVID-19 vaccine are required to have epinephrine auto-injector devices (Epi-Pens) as a safety precaution if an allergic reaction, occurs after the vaccine is given. Epinephrine, also known as adrenaline, is the only medication recommended as a first-treatment medicine in reversing the life-threatening reaction in an anaphylactic attack.

The Training Epinephrine Administrators in Medication (TEAM) is grateful to the Food and Drug Administration’s Peter Marks for personally communicating his direct support and indicating the urgent need for the TEAM’s efforts to expand the training in how to use an epinephrine auto-injector. This training is critical because once an anaphylactic attack occurs, action needs to be taken quickly and the medicine must be administered properly for it to work. There also has been some cases of the auto-injector not working properly.

In addition, studies have shown only one-third to one-half of patients are able to demonstrate the correct technique of use in administering an epinephrine auto-injector and three-quarters of healthcare professionals who treat patients were unable to demonstrate the correct technique and that this is a major risk.

Unfortunately, it took 12 months and a pandemic for other stakeholders, including several epinephrine manufacturers, organizations, and even a select few of the vaunted medical advocacy associations to support epinephrine training. Now that the full support of the FDA and leading physicians, including Dr. Wanda Phipatanakul, a Harvard University Medical School faculty member and pediatrician at Boston Children’s Hospital, and Dr. Myron Zitt, the former president of the American College of Allergy, Asthma, and Immunology.

All are members of TEAM’s advisory board, which advocates for the need for epinephrine auto-injector training and supports HR 7873, the Epi for Dilly Act in Congress. The stakeholder coalition, led by TEAM, is working to enact this bill, which would incentivize states by allowing patients to become trained in epinephrine auto-injector training and rewarding small businesses that adopt epinephrine training.

Most importantly, the public support to expand epinephrine training, while growing, is primed for exponential growth due to the uncertainty among the public of the COVID-19 vaccine. Epinephrine training will enhance Americans’ confidence that should a person receiving the vaccine be stricken by an anaphylactic attack, trained personnel will be able to administer an EpiPen. This urgency is particularly acute for the millions of people who have allergies to any number of foods, environment, and other items.

FDA Commissioner Stephen Hahn’s designated Patient Affairs staff is now working with TEAM to address the issue of the COVID-19 vaccine causing an allergic reaction in some patients. This is the most tangible evidence to date of how health leaders, such as Dr. Marks, Dr. Janet Woodcock (Operation Warp Speed), FDA Commissioner Hahn and their staff, are adhering to the science, and medical integrity in putting the American people first in their highly, and justifiably, scrutinized role in assessing the COVID-19 vaccine for FDA approval.

One of the FDA committee participants, Dr. Paul Offitt of Children’s Hospital Philadelphia, said, “there are tens of millions of people in this country that carry EpiPens because they have peanut allergies and egg allergies. They are going to believe they can’t get the vaccine.” This sentiment, coupled with the higher risk for anaphylaxis associated with asthmatic, underserved, minority populations, lends further urgency for Congress to act and the epinephrine auto-injector training to expand. And I will get the vaccine knowing that the technician delivering the shot is trained in epinephrine auto-injector training.

Robert K. Houton, whose daughter has a life-threatening allergy, is the founder of the Training Epinephrine Administrators in Medication (TEAM) Association. 

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