COVID vaccination and asthma exacerbation: might there be a link?

Int J Infect Dis. 2021 Nov:112:243-246. doi: 10.1016/j.ijid.2021.09.026. Epub 2021 Sep 20.


Introduction: There is ongoing debate regarding the role of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in asthma exacerbation, and its long-term impact on the lung function of individuals with asthma. In contrast, the potential impact of coronavirus disease 2019 (COVID-19) vaccination on asthma is entirely unexplored.

Case study: This study examined a challenging case of severe asthma exacerbation in a 28-year-old female following two doses of the mRNA-based vaccine BNT162b2 (Pfizer-BioNTech) at IRCCS Policlinico San Matteo in Pavia, Italy. The patient, a fourth-year resident at the hospital, was vaccinated in early 2021. She was an occasional smoker with a 10-year history of asthma and seasonal allergic rhinitis. She tested negative for SARS-CoV-2 on several molecular swabs and serology tests.

Results: After receiving the second dose of vaccine, the patient started to experience worsening of respiratory symptoms. Following several episodes and a severe asthma attack, the patient required treatment with mepolizumab, a biologic drug (interleukin-5) antagonist monoclonal antibody.

Conclusion: This single case study is insufficient to draw conclusions about the association between asthma exacerbation and the COVID-19 vaccine. While the cause-effect link between vaccination against SARS-CoV-2 and worsening of asthmatic disease might only be suggested at present, this case is a valuable prompt for further investigation. This is particularly true from the perspective of mass vaccination of adolescents and children currently underway across the globe.

Keywords: Asthma exacerbation; COVID-19 vaccination; Long COVID; Mass vaccination; Monoclonal antibody against interleukin-5; SARS-CoV-2.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Adult
  • Asthma*
  • COVID-19 Vaccines
  • COVID-19*
  • Child
  • Female
  • Humans
  • SARS-CoV-2
  • Vaccination


  • COVID-19 Vaccines