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

Annick Barbaud, Lene Heise Garvey, Alessandra Arcolaci, Knut Brockow, Francesca Mori, Cristobalina Mayorga, Patrizia Bonadonna, Marina Atanaskovic-Markovic, Luis Moral, Giovanna Zanoni, Mauro Pagani, Angèle Soria, Maja Jošt, Jean-Christoph Caubet, Carmo Abreu, Mona Al-Ahmad, Alberto Alvarez-Perea, Sevim Bavbek, Biagioni Benedetta, Bilo M BeatriceNatalia Blanca-López, Gádor Bogas Herrera, Alessandro Buonomo, Gianfranco Calogiuri, Giulia Carli, Josefina Cernadas, Gabriele Cortellini, Gülfem Celik, Semra Demir, Inmaculada Doña, Berna Dursun Adile, Bernadette Eberlein, Faria Emilia, Fernandes Bryan, Tomaz Garcez, Ignacio Garcia-Nunez, Radoslaw Gawlik, Asli Gelincik, Eva Gomes, Jimmy Hc Gooi, Martine Grosber, Theo Gülen, Florence Hacard, Hoarau Cyrille, Christer Janson, Sebastian L Johnston, Lukas Joerg, Seçil Kepil Özdemir, Ludger Klimek, Mitja Košnik, Marek L Kowalski, Semanur Kuyucu, Violeta Kvedariene, Jose Julio Laguna, Lombardo Carla, Susana Marinho, Hans Merk, Elisa Meucci, Martine Morisset, Rosa Munoz-Cano, Francesco Murzilli, Alla Nakonechna, Florin-Dan Popescu, Grzegorz Porebski, Anna Radice, Frederico S Regateiro, Heike Röckmann, Antonino Romano, Ravishankar Sargur, Joaquin Sastre, Scherer Hofmeier Kathrin, Sedláčková Lenka, Sobotkova Marta, Terreehorst Ingrid, Regina Treudler, Jolanta Walusiak-Skorupa, Bettina Wedi, Stefan Wöhrl, Mihael Zidarn, Torsten Zuberbier, Ioana Agache, Maria J Torres

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
JournalAllergy
DOIs
Publication statusE-pub ahead of print - 2 Feb 2022

Bibliographical note

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Keywords

  • COVID 19 vaccine
  • allergy test
  • anaphylaxis
  • mRNA vaccines
  • risk assessment

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