ROCKY ROAD AHEAD FOR NEW FDA CHIEF CALIFF

Final Senate approval by a historically narrow 50-46 vote came only after the White House and Califf's supporters lobbied hard to gain sufficient support, a success that is very different from Califf's 89-4 approval back in 2016. Pressure to help control the high cost of prescription drugs will continue to drive FDA support for developing complex generic drugs and biosimilars. There is pressure to clarify rules governing e-cigarettes;a need to address serious health problems arising from contaminated food and seafood, including significant volumes of imported products;and the safety of cosmetic products, dietary supplements, sunscreens, and other non-prescription products raise additional complex issues.

A Hospital System's Journey Toward Zero Harm: Reducing Postoperative Respiratory Failure

Postoperative respiratory failure is a significant cause of morbidity and mortality. Early identification of patients at moderate to high risk of postoperative respiratory failure is critical to effective prevention strategies. A multi-disciplinary team developed a robust process for the early identification of at-risk patients and the prevention of respiratory failure in the perioperative setting.

Perceived Change in Quality of Life Related to Treatment of Hepatitis C Infection among People with Substance Use Disorder: A Qualitative Study

Background. The hepatitis C virus (HCV) is often associated with people who inject drugs, and with a reduction in quality of life. While earlier forms of HCV treatment had low treatment uptake, newer HCV treatment integrated with opioid maintenance treatment appears to increase treatment uptake among those who inject drugs. The aim was to explore how people who inject drugs perceive changes in quality of life after treatment of HCV infection. Methods. Four focus group discussions, and 19 individual interviews were conducted with people who inject drugs or who had previously injected drugs and received opioid agonist therapy. All participants were successfully treated for and "cured” for HCV. Data were audio-recorded, transcribed verbatim, and analyzed using reflexive thematic analysis. Results. The HCV treatment helped participants to let go of negative thoughts and break destructive patterns of interaction. This facilitated the restoration of social relationships with family and others. Furthermore, some participants reported a general improvement in their health. Feeling healthy meant fewer worries such as infecting others. Also, interactions with health professionals were experienced as less stigmatizing. These physical, social, and psychological improvements led to a form of "awakening” and being treated for HCV gave participants hope for the future. Conclusion. HCV treatment improves the mental and physical health in addition to play an important social function. Successful HCV treatment was associated with a greater sense of hope for the future, reconnection with significant others, and reduced feeling of stigma. Overall, improved health and social relationships contributed to improved quality of life.

No Single Path: Review of Amy Sullivan's Opioid Reckoning

According to this framework, the pandemic is a two-part problem: one part virus, one part social resistance to the cure for the disease. [...]we hear that medical scientists have developed "gold standard" treatments for addiction, but that for reasons of bureaucratic lethargy, public skepticism, or sheer hopelessness among those suffering from addiction, the treatments are not adequately made available and sought out. The stories in the book are drawn from oral-history interviews that the author conducted with family members of people with addictions, doctors, community organizers, and treatment-center directors over a period of four years. Chapter Two reconstructs the life of a single man from the memories of his surviving family members, from the moment of his first exposure to opioids through fourteen separate rounds of addiction treatment and up to the moment of his fatal fentanyl overdose.

Cannabis: Global Histories ed. by Lucas Richert and James H. Mills (review)

Peter Hynd replicates verbatim the language of excise reports in British India to narrate the colonial state's apparently successful fiscal measures to lower cannabis sales and maximize revenue. Besides misnaming Hemchunder Kerr as Dutt and misidentifying the Garhjat in Orissa as Gujarat sixteen hundred kilometers west, Hynd concludes that the infrastructure of cannabis revenue extraction by an oppressive colonial force is that reasonable but rare occasion where "modern governments stand to learn a thing or two from the example set by the British Raj.” Behind the story of the GW Pharmaceuticals product Sativex, Suzanne Taylor uncovers years of lobbying by middle-class citizen groups like the Multiple Sclerosis Society in the 1990s that pushed for controlled medical research on cannabis and gave it a respectable face. [...]the editors' invitation to a renewed research agenda around this assessment, tediously termed "globalization without globalizers,” is constrained by their neglect of the teeming scholarly assessments and critiques of the category "global” and the framework "globalization.” More importantly, in 2022, even as emerging mass spectrometry research on cannabinoid non-psychoactive acids at the Linus Pauling Institute suggest their potential to successfully bind Covid-19 spike proteins against human epithelial cells, states in the Global South continue to face restrictions from global narcotics control institutions on scientific studies of cannabis.

It's Not Always Just a Rash

[...]it may have been difficult to get him admitted since it is not our current practice to admit patients with mild COVID-19 infections. [...]our financial incentives are to see many patients each shift, which does not always leave time to care for more socially challenging cases. Burnout is rising in the field of emergency medicine, and I think a part of that burnout can be attributed to the uphill battle that providers are fighting daily to care for patients that our health system leaves behind.

Imagining a World Without Low-Value Services: Progress, Barriers, and the Path Forward

Am J Manag Care. 2021;27(3):137-139. https://doi.org/10.37765/ajmc.2021.88612 _____ Low-value services—services that provide insufficient clinical benefit relative to cost—are increasingly recognized as a major problem in the US health care system. The pandemic's unprecedented impact on the US health care system, and society writ large, offers an opportunity to reshape the conversation and incentives around low-value services after the immediate crisis subsides. [...]although recent initiatives have raised awareness of low-value care among clinicians, knowledge gaps remain, and researchers and advocates have not effectively communicated the scope or salience of the problem to patients. Currently, many measures are derived from claims data alone, which may be insufficient for nuanced determinations of low-value care. [...]most existing measures focus on encouraging the delivery of underused services, whereas relatively few measures explicitly target overuse or capture the harm precipitated by low-value care.

Prolonged Cessation of Chronic Opioid Analgesic Therapy: A Multidisciplinary Intervention

Am J Manag Care. 2022;28(2):60-65. https://doi.org/10.37765/ajmc.2022.88785 _____ Takeaway Points Building on articles previously published in this journal, this research suggests a potential path toward an effective and sustained clinical approach to decrease chronic opioid analgesic therapy use in the population of patients with chronic, noncancer pain. * We retrospectively examine the initial and sustained success rates of full mu agonist chronic opioid analgesic therapy (COAT) cessation in the setting of chronic, noncancer pain (CNCP) through voluntary participation in a pilot program—implemented via 2 sites and care teams—that provided a standardized, multidisciplinary curriculum containing robust complementary care. * This study provides unusually lengthy follow-up for postintervention COAT cessation monitoring of up to 24 months. * Initial COAT cessation success rates were high, and sustained success at 6 months and beyond was even higher (90%, 95%, and 97%, respectively), indicating that the program curriculum may be an effective strategy for broader application for sustainable COAT cessation in the setting of CNCP. _____ A recent CDC report suggests that years of nationwide medical and managed care regulations to limit prescription opioid access, dose, and time exposure have had minimal positive impact on life expectancy in the United States.1 Despite the wide abandonment of opioid prescriptions by the medical community, opioid-related mortality and morbidity have continued to rise, a trajectory that has accelerated due to the COVID-19 pandemic.1-3 Aside from being a contributor to overdose-related death, full mu agonist chronic opioid analgesic therapy (COAT) has been shown to impede vocational and social return to function and to increase length of disability.1,3,4 Managed care charges for patients with opioid dependency are more than 550% higher than the average annual per-patient charge.5 Also, the population of "opioid refugees" is gaining numbers—patients who were made dependent upon opioids by recent, but now out-of-favor, prescribing practices for the management of chronic pain and are now abruptly unable to find a medical source for the same medications.6 This has moved many patients with chronic pain dependent upon opioids to drastic measures such as seeking new or multiple prescribers, emergency medical care, or even illicit opioid sources.7 The medical community has been trialing and comparing several approaches to combat the ineffective use of COAT for chronic, noncancer pain (CNCP). Some managed care institutions have attempted a model of coverage cessation for these medications, resulting in paradoxically increased costs as patients struggle to cope.3 Clinicians have reported varying levels of success to promote COAT cessation through outpatient weaning8-12 and single-modality approaches of cognitive behavioral therapy (CBT),13,14 acupuncture,10 interdisciplinary programing,15-24 and buprenorphine substitution.20,25-27 None of the data present a definitive, best-practice approach to the challenge of the opioid epidemic in the setting of chronic pain. Every activity was designed for home exercise and was led by a licensed or credentialed expert in that field, such as a physician, nurse practitioner, psychologist, licensed acupuncturist, physical therapist, or licensed physical therapy assistant. Because the PDMP is ubiquitous as a record of presence and volume of prescribed controlled substances in California, with few exceptions (see Discussion), lack of an entry in the PDMP was interpreted as that subject not using opioids.

Payer Strategies to Ensure Access to Care for Individuals With Opioid Use Disorder During COVID-19

[...]increase access to care by reimbursing virtual visits. [...]leverage data to identify and intervene when patients are at risk for recurrence or overdose. In practice, expanded access to buprenorphine reduces diversion and misuse because they occur commonly among individuals seeking relief from withdrawal.2 Compared with buprenorphine monotherapy, buprenorphine-naloxone is associated with lower rates of misuse.2 Mark et al demonstrate that among Medicare beneficiaries, removal of prior authorization for buprenorphine-naloxone doubled treatment rates and significantly reduced emergency department (ED) visits and hospitalizations.4 Ultimately, the lifesaving benefits of expanded access to buprenorphine far outweigh the associated risks. In a time of social distancing, limited personal protective equipment, and transportation barriers, payment and delivery of telehealth is imperative to ensuring access to care. Because many patients do not have reliable access to broadband connection or smartphones, audio-only visits must be reimbursed as well.

A PRESCRIPTION FOR CALAMITY: WHY THE DEPARTMENT OF LABOR'S PHARMACY BENEFIT MANAGEMENT PROGRAM FALLS SHORT AS A SINGULAR SOLUTION TO THE U.S. OPIOID CRISIS

The purpose of this Note is to create a holistic solution for the U.S. Department of Labor to apply amidst the United States ongoing opioid crisis, which will serve to both prevent addiction before it can develop and treat existing cases of addiction. To this aim, this Note examines and analyzes the connections between the opioid crisis and another co-existing public health crisis, the COVID-19 pandemic, and the procurement procedures taken to resolve them. The argument is developed throughout three sections. First, this Note provides background information demonstrating the detrimental impact of opioid misuse and addiction, as well as the impact that COVID-19 in particular has had on rates of misuse and addiction in the United States. ally, this section introduces efforts taken to resolve the crisis, including the Department of Labors Pharmacy Benefit Management program, which is the subject of this Note. Second, this Note examines the Department of Labors Pharmacy Benefit Program, addressing the singularly preventative nature of the program, which fails to support a holistic solution. Additionally, this Note addresses concerns relating to the use of pharmacy benefit management services in general, particularly the cost-increasing nature of such mechanisms. In the final section, following an examination of the procurement procedure used to acquire COVID-19 vaccines, this Note proposes the application of a similar pharmaceutical procurement approach to combatting the opioid crisis. To conclude, this Note argues that by contracting with pharmaceutical companies to develop a safer and less addictive treatment plan, the Department of Labor would be able to prevent, as well as treat, opioid addiction.

Comparing media coverage of the pharmaceutical industry: pre- and post-pandemic lockdown

PurposeThe purpose of this paper is to analyze media coverage of the pharmaceutical industry before and after the COVID-19 lockdown to determine whether the coverage changed in light of a global health-care crisis and the fast-track development of vaccines and antiviral treatments.Design/methodology/approachThe top five US newspapers were audited, comparing the 12-month periods before and after March 2020 coinciding with the pandemic lockdown, yielding 493 front-page articles and editorials. Each headline and full-text article was separately analyzed and categorized as either positive, negative or neutral toward the pharmaceutical industry. A frequency analysis of the hot button issues covered in each article was conducted.FindingsYear 1 and Year 2 audit results were compared to identify changes in media coverage pre- and post-lockdown. The amount of coverage of the industry increased 145% and the tone of both headlines and articles shifted dramatically. Only one of the five newspapers had a net positive article rating of the industry pre-lockdown, four of five were net positive post-lockdown. The proportion of positive headlines increased 165%. The top issues discussed in the coverage shifted from persistent challenges for the industry (e.g. opioid crisis, high cost of drugs) to the emergence of the virus and status of vaccine development.Originality/valueThis research establishes how media coverage of the pharmaceutical industry changed as the industry responded to a global health-care crisis and identifies implications for industry stakeholders.

Missouri's Public Health at a Glance

According to the 2021 Behavioral Risk Factor Surveillance Survey, with an obesity prevalence rate of 37-2% in adults, Missouri continues to outpace the national average of 33-9%. The model described at https://wwwhealthiermo. org/-the Foundational Public Health Services (FPHS)-aims to assure six core public health programmatic areas are available through every public health agency: chronic disease prevention, communicable disease control, environmental public health,;injury prevention, maternal, child and family health, and linkages to medical, behavioral, and community resources. With funding from the Centers for Disease Control and Prevention (CDC), DHSS will lead an effort over the next four to five years to conduct a cost analysis for full implementation of the FPHS model statewide, as well as an accountability measure planning effort with a diverse group of stakeholders inclusive of county and state policymakers. DHSS Chief Medical Officer Heidi Miller, MD, MSMA member and an internal medicine physician with extensive experience with uninsured, Medicaid and underinsured populations, joined DHSS as the department's first Chief Medical Officer in January 2023- Dr. Miller will provide medical guidance and expertise to DHSS programs, serve as the liaison with medical associations and providers, be instrumental in program and protocol development, and continue to build and implement the vision of an integrated public health and healthcare system.

Localized Syndemic Assemblages: COVID-19, Substance Use Disorder, and Overdose Risk in Small-Town America

Pandemics do not exist in isolation and COVID-19 is no exception. We argue that existing health crises, notably substance use disorder (SUD), developed syndemic relationships with COVID-19 that produced compounding deleterious effects. Combining Merrill Singer's theory of syndemics and assemblage theory, we analyze the combinatory impact of overdose and COVID-19 within a localized context. We focus on Sandusky, Ohio, where we combine police reports, in-depth interviews with area residents, and ethnographic data to compare conditions before and after the emergence of COVID-19. We find dramatic shifts in relevant local contexts due to COVID-19, inhibiting existing systems of law and public policy aimed at overdose prevention and SUD treatment. Further, our findings provide evidence of complications in the COVID-19 response originating from the overdose epidemic.

Data is the New Protein: How the Commonwealth of Virginia Built Digital Resilience Muscle and Rebounded from Opioid and COVID Shocks

During shocks, residents and businesses rely upon the government to ensure health, safety, and the continuity of services. The government's ability to respond depends upon how well it utilizes its data resources and builds digital resilience. Yet governments often fail to integrate data from different agencies to respond effectively to shocks. We conceptualize digital resilience as a dynamic capability (DC). Although the DC framework provides a theoretical basis, it is unclear what actions managers can take to build DC. Through process tracing, we examine how the Commonwealth of Virginia (COVA) built DCs and rebounded from two shocks-the opioid crisis and the COVID-19 pandemic. COVA managers leveraged statewide data assets, built routines to disseminate data, and reconfigured operational capabilities to build three DCs-relationship building, intelligence creation, and value extraction. Data functioned as the "protein" to build the digital resilience "muscle." We found that the relationship building DC leveraged the operational capabilities of data management, integration, and governance structure to foster data sharing, the intelligence creation DC leveraged analytics, and the value extraction DC converted analytics into cost savings, revenue generation, and new services. Whereas COVA built robust digital resilience by facilitating data sharing, the agencies exploited data assets to develop scalable solutions.

REVIEW ON PREVENTION OF COVID-19: MIRACULOUS NATURAL HERBS

Currently, the novel and major life-threatening cause all over the world is COVID-19 (Coronavirus disease 2019) which is started at the end of 2019 in Wuhan, China, and spread all over the world today. The infection of COVID-19 severity is variable which affects all ages' people and especially elderly persons whose immune system is very weak. Fatigue, fever, respiratory illness, dry cough, loss of appetite, olfactory dysfunction are the most common symptoms of this disease along with the decrease of certain cells of the immune system like helper T cells, monocytes/macrophages, etc. and an increase in pro-inflammatory cytokines are some of the major characteristics of this disease. Some natural herbal products are a successive option to combat SARS-Cov-2 disease. Herbs have various potential compound which is used as a dietary product that strongly influences immunity and maintenance of the homeostasis of inflammatory/anti-inflammatory. In the present review, we describe the potential of three herbal products as Turmeric (Haldi), Heart-leaved moonseed (Giloy), and Black cumin (Kalonji) that can be used for preventative or nutritional therapy of COVID-19.

Who You Gonna Call?

MSMA has successfully spearheaded additional reforms to reduce lawsuit abuse: expert witness reforms that require testimony to be based on evidence widely accepted by the scientific community, updates to the collateral source rule so plaintiffs can only recover actual monetary damages instead of billed charges and increasing the standard of proof for punitive damage claims. There are many groups, including the state's trial attorneys, the hospitals, integrated healthcare systems, pharmacy benefit managers, pharmacy chains, health insurers, and many others that are in Jefferson City every day often pushing positions that are at odds with what is best for our patients. Select Legislation important for Physicians and Patients that MSMA Passed or Blocked 2010 * Insurance company prompt pay (signed into law) * Naturopath licensure and scope expansion (blocked) * Private Medicaid fraud lawsuits (blocked) * Statute of limitations expansion for medical malpractice cases and weakening of the collateral source rule (blocked) * Tiering of physicians (blocked) * Autism insurance coverage (signed into law) 2011 * Drug testing of surgeons (blocked) * Chiropractors Medicaid payment (blocked) * Allowing professional counselors to diagnose (blocked) * Board of Healing Arts civil penalties (blocked) * Implementation of concussion protocols for student athletes (signed into law) * Preemption of local tobacco laws (blocked) 2012 * Increased use of ignition interlock devices (signed into law) * Regulations on the creation and operation of HIEs (signed into law) * Lay midwife licensure (blocked) * CRNA scope expansion (blocked) * Co-pay equity between primary care physicians and physical therapists (blocked) 2013 * Prompt credentialing improvements (signed into law) * Telehealth reimbursement parity (signed into law) * Repeal of collaborative practice act (blocked) * Volunteer physician malpractice immunity (signed into law) * Updating of newborn screening requirements (signed into law) * Mandatory arbitration for claims over 30 days unpaid (blocked) 2014 * Non-physician clinicians scope expansion (blocked) * Tanning bed parental permission (signed into law) * Establishment of ECHO telehealth distance learning program (signed into law) * Statewide Medicaid managed care implementation (blocked) 2015 * Tort reform (signed into law) * Establishment of direct primary care services (blocked) * Expansion of APRN scope-of-practice (blocked) * Parental notification of immunization exemptions (signed into law) 2016 * Telehealth expansion (signed into law) * Prohibit MOC/MOL for licensure (signed into law) * Licensure not conditioned on participating in any health insurance plan (signed into law) * Step therapy reform (signed into law) * Insurance contracts gag clauses banned (signed into law) * APRN, athletic trainers, physical therapists, radiology technicians scope expansion (blocked) 2017 * Expert witness reform (signed into law) * Collateral source rule updated (signed into law) * Tort reform fix for hospital non-employees (signed into law) * Requirements for medical student mental health and wellbeing (signed into law) * APRN opioid prescriptive authority expansion (blocked) * Implementation of statewide naloxone protocol (signed into law) 2018 * Protection of prudent layperson standard in the ER (signed into law) * Prohibit pharmacy gag clauses (signed into law) * Non-physician clinicians, physical therapists, radiology technicians scope expansion (blocked) * Implementation of workers compensation fee schedule (blocked) * Increased Medicaid post-partum benefits (signed into law) 2019 * Prior authorization reform (signed into law) * Prohibit use of virtual credit cards by insurers (signed into law) * Establishment of pregnancy-associated mortality review board (signed into law) * Implementation of statewide MAT insurance coverage for opioid disorders (blocked) * Defeat of various anti-vaccination requirements for physicians (blocked) * Independent pharmacist prescribing (blocked) 2020 * Punitive damages only for intentional or malicious act (signed into law) * Prompt credentialing to pay from the date of application (signed into law) * Overpayment transparency (signed into law) * Vaping prohibitions (signed into law) * Criminal penalties for gender dysmorphia treatments (blocked)

Internal and External Resources Relied on by Established Twelve Step Fellowship Members for Their Recoveries.

Background: The Twelve Steps described by Narcotics Anonymous (NA) and Alcoholics Anonymous denote key aspects of how members can achieve abstinence from alcohol and other drugs. However, there are limited empirical findings on what long-term members rely on to support their ongoing recovery.Method: In order to clarify the members' reliance on those latter resources, we surveyed 2,293 long-term NA members through the internet on items they rely on for their recovery. They scored nine NA-related resources (e.g., their sponsor) and three non-NA institutional ones (e.g., a professional therapist).Results: Three factors accounted for 53.6% of the variance in the respondents' scores of the 12 items. We labeled them, with the percent of variance accorded, as NA-based social (24.9%) support, spiritual (17.8%) support, and outside professional (10.9%) help. While NA-based resources ranked highest, outside resources (a house of worship, a therapist, or medications for psychological distress) were scored by 75.4% of the respondents. Analysis by subgroups of respondents reflected the diversity of resources members draw on. The use of internet-based meetings during the COVID-19 period reflected the resilience of the NA format.Conclusion: Members of Twelve Step programs can be studied to shed light on options that they rely on for support for their ongoing recovery, both within the fellowships and outside them. Long-term members can apparently rely on resources inside the fellowship and simultaneously on professional ones, as well. These findings can be helpful for researchers in considering mechanisms that underlie long-term Twelve Step-related recovery and for clinicians in employing both these fellowships and outside resources as adjuncts to their professional care.

Changing drug overdose deaths patterns where US rates are highest: global implications

BackgroundWest Virginia(WV) drug poisoning rates were low before 2000 but now are the nation’s highest. We explore the role of excessive opioid prescribing in imitating this epidemic.MethodsWV age-adjusted overdose fatality trends 1979 to 2020 were examined along with toxicology data from our medical examiner(ME) containing drug levels on all drug-involved deaths in WV. Percapita opioid prescribing rates was available 1997–2017.ResultsFatal drug overdose rates increased from 3.3/100,000 in 2000 to 83.6 in 2000. WV percapita morphine milligram equivalent (MME) opioid prescription rates increased from 137 in 1997 to 1,171 in 2011 (850% increase) but decreased to 554 in 2017. Corresponding with 2012 decline in prescribed opioids, prescription drug involvement deaths declined steadily while 2011–2013 overall overdose rates flattened. However, in 2012 heroin deaths began rising. In 2014 introduction of fentanyl began an unprecedented increase in overall fatality rates peaking in 2017. In 2018–19 rates declined but began to rise again corresponding with COVID-19 pandemic. More detailed time series analyses of temporal correlations of opioid prescription and overdose rates, including multivariate trends will be presented.DiscussionUnlike urban drug problems, the WV epidemic origins are largely iatrogenic, starting with extremely high opioid prescription rates. As predicted by the Iron Law of Prohibition, sudden decreases in the availability of prescription opioids were associated with an increased use of illicit, more potent opioids. This presentation will outline the progression of the rural drug problem in WV including harm-reduction efforts.Learning OutcomesDiscuss global implications of findings and lessons learned.

Allergic History and Anaphylaxis in COVID-19 Vaccines: A Disproportionality Analysis in the FDA Vaccine Adverse Event Reporting System: An International Journal of Medical Toxicology and Drug Experience

Introduction: Many pre- and post-marketing studies on Covid-19 vaccines investigated their safety in the overall population. Little information is available on cohorts with specific comorbidities. Few studies evaluate the safety in allergic subjects, in particular as related to the anaphylaxis risk. Objective: To investigate the association between anaphylaxis after Covid-19 vaccines and the history of hypersensitivity reactions to the most common allergens. Methods: The Vaccine Adverse Event Reporting System (VAERS, January 2020-December 2021) was downloaded and cleaned. We focused on reports of Adverse Events Following Immunization (AEFIs) following COVID-19 vaccination in subjects > 12 years old with history of allergy. We performed a descriptive analysis and calculated the Reporting Odds Ratio (ROR) to identify demographic characteristics and allergic histories disproportionally reported with anaphylaxis for each Covid-19 vaccine and the most recorded allergens. Results: We retrieved 183,860 AEFI reports recording any allergic history (864 anaphylaxis reports among cases vs 6,162 in Covid-19 reports without history of allergy). They concerned mostly women (81.3%) and adults (74.0%). Almost all reports were submitted in the US (99.7%) and 38.3% of them resulted in hospitalization. Covid-19 vaccines administered were Spikevax (49.3%), Comirnaty (42.1%), and Janssen (8.4%). The antigens most recorded as allergens were penicillins (49,407), sulfa drugs (37,365), opioids (26,398), seafood (12,039), latex (11,442), NSAIDs (11,319), cephalosporins (8,379), quinolones (8,023), macrolides (7,586). Seafood allergy resulted associated with anaphylaxis for Comirnaty (ROR = 2.80;95% CI 2.20-3.56), Spikevax (2.57;1.88-3.51), and Janssen (2.67;1.39-5.11). Latex allergy was associated with anaphylaxis for Comirnaty (ROR = 1.92;95% CI 1.45-2.55). Conclusion: We gathered evidence pointing towards a preferential development of anaphylaxis in patients with an history of hypersensitivity to seafood (for all Covid-19 vaccines) or latex (restricted to Comirnaty). Whether confirmed by further studies, this knowledge may drive a more practical anamnesis and a prompt management of anaphylactic reactions.