We would like to share ideas on the publication “Delayed-onset Anaphylaxis After mRNA-Based COVID-19 Vaccination in an Adolescent Male.”[1] According to Shrestha et al, this instance underlines the significance of creating good AEFI surveillance mechanisms, as well as prolonging patient monitoring after COVID-19 vaccination with proper AEFI counseling.[1] We agree that the COVID-19 vaccine could induce a variety of clinical issues, including anaphylaxis. The patient in this case suffered anaphylaxis, however concluding that there is a definite causal with vaccination is problematic. Because there is no information on the patient’s health or immunologic condition before immunization, the correlation may be ambiguous. In this situation, there is also the possibility of a concurrent medical condition that could lead to anaphylaxis. A vaccination recipient’s clinical problems after vaccination are not always caused by the immunization. For example, dengue is a possible clinical problem that can occur in a vaccine recipient.[2] Delayed type hypersensitivity is also a known clinical problem in the pathophysiologic process of dengue.[3]