Immune Response in Regard to Hypersensitivity Reactions after COVID-19 Vaccination

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), is a member of the genus Betacoronavirus. This virus was first detected in December 2019, and the situation quickly escalated to cause a global pandemic within a few months. COVID-19 had caused more than 5.5 million deaths as of January 2022. Hence, the urgency of effective vaccination contributed to the fastest rate of vaccine development seen to date (i.e., within 1.5 years). Despite reports of good vaccine efficacy without severe systemic reactions at the clinical trial stage, hypersensitivity reactions have been reported following worldwide vaccination campaigns. We provide a brief review regarding the structure of SARS-CoV-2. We also review the most acceptable types of vaccines in terms of safety profiles, namely the BNT162b2, mRNA-1273, and AZD1222 vaccines. This review aims to facilitate an understanding of the possible immune mechanisms regarding COVID-19-vaccination-related hypersensitivity reactions, such as thrombosis and thrombocytopenia, cutaneous adverse reactions, myocarditis, and perimyocarditis.

Health and Well-Being through COVID-19 Vaccination: Physical, Oral, and Psychological Effects

“…Serious adverse events, including thromboembolic events, stroke, myocardial infarction, and sudden death, have been reported in rare cases following COVID-19 vaccination [ 16 , 17 ]. Although the incidence of such events remains low, the underlying causality is unclear.…”

Basophil Activation Test with Different Polyethylene Glycols in Patients with Suspected PEG Hypersensitivity Reactions

“…Polyethylene glycol (PEG) and polysorbate 80 (PS80) were therefore identified as causal allergens contained in mRNA and viral vector-based vaccines, respectively [ 2 , 11 , 12 , 13 , 14 , 15 , 16 ]. Polysorbate 80 (PS80) is a non-ionic detergent used to solubilize proteins and is present in viral vector COVID-19 vaccines (i.e., Janssen/J&J Ad26.COV2.S and Oxford/AstraZeneca ChAdOx1-S) [ 17 ]. However, mRNA vaccines contain the mRNA encoding for the full-length SARS-CoV-2 spike (S) protein [ 18 ], protected and encapsulated within lipid nanoparticles (LNPs).…”

“…The allergological work-up programs for the evaluation of the allergic potential of allergens contained in COVID-19 vaccines were mainly focused on PEGs, given that in Italy, as in many other countries, the viral vector-based vaccines were withdrawn from the market [ 24 ]. For these reasons, the most widely used allergological work-up program for the evaluation of COVID-19 vaccine allergies included the administration of a skin prick test (SPT) with PEG-containing products; an intradermal test (IDT) and sIgE evaluation were also applied [ 17 , 25 , 26 ]. Notably, it has been demonstrated that, in this context, the reproducibility of the SPT test is time-dependent and reactivity will decline over time [ 24 ].…”