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.

A single dose of intramuscular dexamethasone added to nebulized L-epinephrine, or salbutamol therapies resulted in better outcome measures than bronchodilators alone in the late phase (fifth day) of mild to moderate degree bronchiolitis attack. However, effects of EPI + DEX combination was not different from SAL + DEX combination.

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Background: Antiepileptic drugs (AEDs) are widely used for the treatment of epilepsy, but they can be associated with the development of mainly delayed/non-immediate hypersensitivity reactions (HRs). Although these reactions are usually cutaneous, self-limited and spontaneously resolve within days after drug discontinuation, sometime HRs reactions to AEDs can be severe and life threatening. Aim: This paper seeks to show examples on practical management of AEDs HRs in children starting from a review of what it is already known in literature. Results: Risk factors include age, history of previous AEDs reactions, viral infections, concomitant medications and genetic factors. The diagnosis work-up consists of in vivo (Intradermal testing and Patch testing) and in vitro tests [serological investigation to exclude the role of viral infection,

Interpretation of tuberculin reactions in revaccinated children is somewhat controversial among paediatricians. In this study, the effect of the number of BCG vaccines on tuberculin reactivity is evaluated. In 2810 healthy children aged 7 to 14 years with purified protein derivative (PPD) testing. Children were grouped according to the concordance of the number of the reported/documented vaccinations to the number of scars. Group 1 and 2 comprised of children 7 to 10 years of age and 11 to 14 years of age respectively, who had non-concordant scar numbers, and Group 3 and 4 included 7 to 10 and 11 to 14 years old children with concordant scar numbers. Mean tuberculin induration sizes were 8.0 +/- 5.7 mm for Group 1, 10.6 +/- 4.9 mm for Group 2, 9.8 +/- 4.9 mm for Group 3 and 10.9 +/- 4 mm for Group 4. As the time interval after the last dose of vaccination increased, mean induration sizes decreased in Group 1 and Group 3. In contrast, the mean reaction sizes of Group 2 and Group 4 showed a positive correlation with the period after the last dose of vaccine. It seems advisable that an induration size > or = 15 mm should not be attributed to BCG vaccination in countries with a high tuberculosis infection prevalence and routine BCG revaccination policies. A detailed investigation for tuberculosis infection and disease should be performed in those cases.