Allergies and COVID‐19 vaccines: An ENDA/EAACI Position paper

Background Anaphylaxis, which is rare, has been reported after COVID‐19 vaccination, but its management is not standardized. Method Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questi...

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Published in:Allergy (Copenhagen) Vol. 77; no. 8; pp. 2292 - 2312
Main Authors: Barbaud, Annick, Garvey, Lene Heise, Arcolaci, Alessandra, Brockow, Knut, Mori, Francesca, Mayorga, Cristobalina, Bonadonna, Patrizia, Atanaskovic‐Markovic, Marina, Moral, Luis, Zanoni, Giovanna, Pagani, Mauro, Soria, Angèle, Jošt, Maja, Caubet, Jean‐Christoph, Carmo, Abreu, Mona, Al‐Ahmad, Alvarez‐Perea, Alberto, Bavbek, Sevim, Benedetta, Biagioni, Bilo, M.Beatrice, Blanca‐López, Natalia, Bogas, Herrera Gádor, Buonomo, Alessandro, Calogiuri, Gianfranco, Carli, Giulia, Cernadas, Josefina, Cortellini, Gabriele, Celik, Gülfem, Demir, Semra, Doña, Inmaculada, Dursun, Adile Berna, Eberlein, Bernadette, Faria, Emilia, Fernandes, Bryan, Garcez, Tomaz, Garcia‐Nunez, Ignacio, Gawlik, Radoslaw, Gelincik, Asli, Gomes, Eva, Gooi, Jimmy H. C., Grosber, Martine, Gülen, Theo, Hacard, Florence, Hoarau, Cyrille, Janson, Christer, Johnston, Sebastian L., Joerg, Lukas, Kepil Özdemir, Seçil, Klimek, Ludger, Košnik, Mitja, Kowalski, Marek L., Kuyucu, Semanur, Kvedariene, Violeta, Laguna, Jose Julio, Lombardo, Carla, Marinho, Susana, Merk, Hans, Meucci, Elisa, Morisset, Martine, Munoz‐Cano, Rosa, Murzilli, Francesco, Nakonechna, Alla, Popescu, Florin‐Dan, Porebski, Grzegorz, Radice, Anna, Regateiro, Frederico S., Röckmann, Heike, Romano, Antonino, Sargur, Ravishankar, Sastre, Joaquin, Scherer Hofmeier, Kathrin, Sedláčková, Lenka, Sobotkova, Marta, Terreehorst, Ingrid, Treudler, Regina, Walusiak‐Skorupa, Jolanta, Wedi, Bettina, Wöhrl, Stefan, Zidarn, Mihael, Zuberbier, Torsten, Agache, Ioana, Torres, Maria J.
Format: Journal Article
Language:English
Published: Denmark Blackwell Publishing Ltd 01.08.2022
Wiley
Subjects:
Allergens
Allergies
allergy test
Anaphylaxis
Anaphylaxis - diagnosis
COVID-19
COVID-19 - prevention & control
COVID-19 vaccine
COVID-19 vaccines
COVID-19 Vaccines - adverse effects
Drug Hypersensitivity - diagnosis
Drug Hypersensitivity - etiology
Drug Hypersensitivity - therapy
Humans
Immunization
Life Sciences
mRNA
mRNA Vaccines
Polyethylene glycol
risk assessment
Skin tests
Vaccines
Vaccines, Synthetic
allergy test
mRNA vaccines
risk assessment
COVID-19 vaccine
anaphylaxis
ISSN:0105-4538, 1398-9995, 1398-9995
Online Access:Get full text
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Summary:Background Anaphylaxis, which is rare, has been reported after COVID‐19 vaccination, but its management is not standardized. Method Members of the European Network for Drug Allergy and the European Academy of Allergy and Clinical Immunology interested in drug allergy participated in an online questionnaire on pre‐vaccination screening and management of allergic reactions to COVID‐19 vaccines, and literature was analysed. Results No death due to anaphylaxis to COVID‐19 vaccines has been confirmed in scientific literature. Potential allergens, polyethylene glycol (PEG), polysorbate and tromethamine are excipients. The authors propose allergy evaluation of persons with the following histories: 1—anaphylaxis to injectable drug or vaccine containing PEG or derivatives; 2—anaphylaxis to oral/topical PEG containing products; 3—recurrent anaphylaxis of unknown cause; 4—suspected or confirmed allergy to any mRNA vaccine; and 5—confirmed allergy to PEG or derivatives. We recommend a prick‐to‐prick skin test with the left‐over solution in the suspected vaccine vial to avoid waste. Prick test panel should include PEG 4000 or 3500, PEG 2000 and polysorbate 80. The value of in vitro test is arguable. Conclusions These recommendations will lead to a better knowledge of the management and mechanisms involved in anaphylaxis to COVID‐19 vaccines and enable more people with history of allergy to be vaccinated.
Bibliography:Deceased
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ISSN:0105-4538
1398-9995
1398-9995
DOI:10.1111/all.15241