On January 11th 2021, the vaccination Center in Lausanne, a city of 140’000 inhabitants in western Switzerland, started the COVID-19 vaccination with mRNA-based vaccines. As of February 9th, 13296 vaccine doses were administered with 12349 patients receiving a 1st dose (10501 Pfizer/BioNTech, 1848 Moderna) and 947 receiving a 2nd dose (945 Pfizer/BioNTech, 2 Moderna). We report a case series of 9 patients with stage III hypertension documented within minutes of vaccination during the first 30 days, of which 8 were symptomatic.
Vital signs were measured with an oscillometric manometer (Omron Heathcare Europe, a HEM 907-E7) with at least 3 sets of separate values at 5-minute intervals.
Median age was 73 (IQR 22), sex distribution was 7 females for 2 males. Eight of 9 patients had a prior history of arterial hypertension with most patients on anti-hypertensive therapy. All but one patient received the Pfizer/BioNTech (BNT162b2) vaccine. Of note, the Moderna (mRNA-1273) vaccine was only introduced in late January in Switzerland. One of the patients (n°3) reported a cerebral aneurysm that was coiled within the last year, with a targeted SBP < 140mmHg. 1 Due to developing headache, the patient underwent imaging with no sign of intracranial hemorrhage. Patient n°4 did not have associated electrocardiogram changes or an increase in hs-troponins. Importantly, all patients recovered but required at most several hours of monitoring at our tertiary center’s emergency department.