Safety of New mRNA Vaccines Against COVID-19 in Severely Allergic Patients

Rojas-Pérez-Ezquerra, Patricia; Quirós, Jimena Crespo; Molina, Pampa; Ocariz, Maria Luisa Baeza Ochoa de; Zubeldía, J M

doi:10.18176/jiaci.0683

Cited by 27 publications

(30 citation statements)

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“…Other groups [ 27 , 46 ▪▪ , 47 , 55 ] indicate a need for testing several molecular weight PEGs. Moreover, SPT with lower molecular weight PEGs may require greater test concentrations to elicit a response [ 27 , 46 ▪▪ , 56 ]. Due to the risk of systemic allergic reactions on skin prick testing several groups recommend using a stepwise method, with gradually increasing molecular weights and concentrations of PEG; however, the data behind these recommendations originate from only few patients [ 27 , 36 ▪▪ , 37 , 46 ▪▪ ].…”

Section: Excipents In the Vaccines Potentially Causing Anaphylaxismentioning

confidence: 99%

Vaccine allergy: evidence to consider for COVID-19 vaccines

Nilsson

Csuth

Storsæter

et al. 2021

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of reviewWhereas the COVID-19 pandemic has changed our lives worldwide, we hope that vaccination can combat the disease. We propose how to evaluate suspected severe allergic reactions to the vaccines so that as many as possible may be safely vaccinated. Recent findingsRare cases of severe allergic reactions after COVID-19 vaccination have been observed, seemingly at a higher frequency than for other vaccines. Few excipients are likely to have caused these reactions. IgEmediated reactions to polyethylene glycol (PEG) and its derivatives are the most suspected, albeit hitherto unproven, causes. We suggest to make a diagnosis based on skin tests with PEG and PEG derivatives and that these be considered in relation to the decisions required before the first and the second vaccine dose. A vaccine without these excipients is available, but published data about its side effects are limited.

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Section: Excipents In the Vaccines Potentially Causing Anaphylaxismentioning

confidence: 99%

Vaccine allergy: evidence to consider for COVID-19 vaccines

Nilsson

Csuth

Storsæter

et al. 2021

Current Opinion in Allergy &Amp; Clinical Immunology

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“…Beside prophylactic treatments, most authors reported the implementation of diagnostic algorithms to stratify patient risk. One approach consisted in performing pre-vaccine skin tests in all patients with a history of severe allergic reactions, regardless of a specific history suggesting sensitisation to one or more vaccine components [ 41 ]. Other authors instead triaged patients predominantly with history taking, thus limiting skin tests with either the vaccine and/or its excipients to patients with a higher pre-clinical probability of showing positive signals.…”

Section: Allergic and Mast-cell Disordersmentioning

confidence: 99%

“…No patient has so far been reported with positive skin tests to one or more vaccines. Strikingly, of 226 patients who underwent a clinical/skin-test triage to confirm their fitness to safely receive anti-SARS-CoV-2 vaccination, only one (0.44%) had a mild immediate-type reaction at least after the first dose, possibly suggesting that these relatively simple approaches are feasible to apply in the normal clinical practice [ 41 , 45 ].…”

Section: Allergic and Mast-cell Disordersmentioning

confidence: 99%

Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases

et al. 2021

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Aberrant deployment of the immune response is a hallmark pathogenic feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-related disease (COVID-19), possibly accounting for high morbidity and mortality, especially in patients with comorbidities, including immune-mediated disorders. Immunisation with SARS-COV-2 vaccines successfully instructs the immune system to limit viral spread into tissues, mitigate COVID-19 manifestations and prevent its most detrimental inflammatory complications in the general population. Patients with immune-mediated diseases have been excluded from vaccine registration trials, foreclosing the acquisition of specific efficacy and safety data. In this review, we aimed to summarise and critically discuss evidence from real-world studies addressing this issue to provide a comprehensive view of the impact of vaccination practices in patients with allergy, autoimmunity or immunodeficiency. We analysed clinical and laboratory data from 34 studies involving more than 13,000 subjects with various immune disorders who were vaccinated with mRNA- DNA- or inactivated viral particle-based vaccines. These data globally support the safe and effective use of SARS-CoV-2 vaccines in patients with immune-mediated diseases, although patient-tailored strategies to determine vaccination timing, vaccine choice and background therapy management are warranted to optimise vaccination outcomes. More data are needed regarding patients with primary immunodeficiencies.

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“…Anaphylactic reactions were associated with history of allergy to different foods including cow’s milk, nuts, egg, shellfish, and tropical fruits. Rojas-Pérez-Ezquerra P et al [ 49 ] prospectively investigated 131 patients with previous severe allergic reactions to determine whether mRNA COVID-19 vaccines could be safely given. Patients had an history of anaphylaxis (121/131,92.4%) to drugs (66/121, 54.5%), foods (40/121, 33.1%), hymenoptera venom (4/121, 3.3%), latex (4/121, 3.3%), other allergens (10/121, 8.3%) or idiopathic (3/121, 2.5%).…”

Section: Vaccination In Patients With Food Allergymentioning

confidence: 99%

COVID-19 Vaccines in Children with Cow’s Milk and Food Allergies

Liotti

Bianchi

Bottau³

et al. 2021

Nutrients

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The COVID-19 pandemic is the most challenging global health crisis of our times. Vaccination against COVID-19 plays a key role to control the current pandemic situation. The risk of allergic reactions to new COVID-19 vaccines is low. However, there is a debate on the safety in allergic patients following post marketing findings by different agencies. Our aim is to understand from current experiences whether children with cow’s milk or food allergy are at higher risk than a general population for allergic reactions to COVID-19 vaccines. Current data indicate that patients with a history of allergy to cow’s milk or other foods, even if severe, should receive COVID-19 vaccine in a setting with availability of treatments for anaphylactic reactions and under medical supervision. Recipients should be discharged after a protracted observation period of 30 min if no reaction developed.

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Safety of New mRNA Vaccines Against COVID-19 in Severely Allergic Patients

Cited by 27 publications

References 0 publications

Vaccine allergy: evidence to consider for COVID-19 vaccines

Vaccine allergy: evidence to consider for COVID-19 vaccines

Challenges to Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Diseases

COVID-19 Vaccines in Children with Cow’s Milk and Food Allergies

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