Skin testing with Pfizer SARS-CoV-2 vaccine and PEG 2000

Vieira, João; Marcelino, João; Ferreira, Fátima; Farinha, Sofia; Silva, Rita; Proença, Miguel; Tomáz, Elza

doi:10.5415/apallergy.2021.11.e18

Cited by 11 publications

(24 citation statements)

References 5 publications

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“…The full texts of the 416 remaining articles were reviewed, and 390 irrelevant articles were excluded. As a result, we identified 26 studies that met our inclusion criteria [ 18 – 41 ]. The detailed characteristics of the included studies are shown in Tables 1 and 2 .…”

Section: Resultsmentioning

confidence: 99%

“…The detailed characteristics of the included studies are shown in Tables 1 and 2 . Among the included studies, 12 reported anaphylaxis reactions [ 22 , 25 , 27 , 29 , 33 – 36 , 38 – 40 ], 17 reported nonanaphylactic reactions [ 18 – 24 , 26 – 28 , 30 – 32 , 35 , 37 , 39 , 41 ], and 3 studies reported both anaphylactic and nonanaphylactic reactions ( 27 , 35 , 40 ). The majority of studies reporting incidence rates of anaphylaxis and nonanaphylactic reactions were conducted based on registry databases [ 22 , 24 , 30 , 33 , 39 , 40 ], and most were from hospital and/or emergency department admission databases [ 18 , 19 , 21 – 23 , 25 – 28 , 30 – 36 , 38 – 41 ].…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, 12 reported anaphylaxis reactions [ 22 , 25 , 27 , 29 , 33 – 36 , 38 – 40 ], 17 reported nonanaphylactic reactions [ 18 – 24 , 26 – 28 , 30 – 32 , 35 , 37 , 39 , 41 ], and 3 studies reported both anaphylactic and nonanaphylactic reactions ( 27 , 35 , 40 ). The majority of studies reporting incidence rates of anaphylaxis and nonanaphylactic reactions were conducted based on registry databases [ 22 , 24 , 30 , 33 , 39 , 40 ], and most were from hospital and/or emergency department admission databases [ 18 , 19 , 21 – 23 , 25 – 28 , 30 – 36 , 38 – 41 ]. A total of 26,337,421 mRNA SARS-CoV-2 vaccines recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were included in the systematic review and meta-analysis, 89.1% [ 23 ] of whom were part of the US-VAERS [ 24 , 30 , 39 , 40 ] and Ontario’s vaccine safety surveillance system to report anaphylactic and nonanaphylactic events [ 33 ].…”

Section: Resultsmentioning

confidence: 99%

“…Patients experienced no allergic reactions Riad et al 2021 [ 37 ], The Czech Republic A cross-sectional self-administered online questionnaire About 50.2% of participant were ≤ 43 years old 100 (11.4) About 21.8% and 5.9% of participants reported a history of asthma and allergy, respectively Patients reported no prior history of anaphylaxis Pfizer-BioNTech, dose 1 AND dose 2 Not reported Rash (n = 28), urticaria (n = 10), tongue tingling (n = 5), and swollen lips (n = 4) – – – – (NOS; 6) Incidence of nonanaphylactic reactions per 106 doses = number of nonanaphylactic cases [47]/doses administered [877] ≈ 53,592 Rash and urticaria were more common among the ≤ 43 years old group than the older age group Shimabukuro et al 2021 [ 39 ], United States National passive surveillance (spontaneous reporting) after immunization captured in the VAERS Median [range], 43 [22–96] 4 (9.3) For 26/43 (60%) case reports, a past history of allergies or allergic reactions, mostly to foods and drugs, was documented Patients reported no prior history of anaphylaxis Moderna, dose 1 15 (< 1–1,440 [24 h]) Commonly symptoms included pruritus, rash, itchy sensations in the mouth and throat, sensations of throat closure, and respiratory symptoms – – All patients had recovered or been discharged home. No deaths from anaphylaxis were reported - (NOS; 6) Incidence of vaccine-triggered anaphylaxis per 106 doses = number of anaphylaxis cases [43]/doses administered [4,041,396] = 10.6 CDC physicians evaluated these reports and applied Brighton Collaboration case definition criteria to classify case reports as anaphylactic or nonanaphylactic About 26/43 (60%) of the nonanaphylactic allergic reactions were classified as nonserious Vieira et al 2021 [ 41 ], Portugal Prospective cohort, single center 31 0 (0) Allergic rhinitis Sixty reported a previous history of drug anaphylaxis ...…”

Section: Methodsmentioning

confidence: 99%

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Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

Alhumaid

Mutair

Alawi

et al. 2021

Allergy Asthma Clin Immunol

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Background Currently there is no systematic review and meta-analysis of the global incidence rates of anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines in the general adult population. Objectives To estimate the incidence rates of anaphylactic and nonanaphylactic reactions after COVID-19 vaccines and describe the demographic and clinical characteristics, triggers, presenting signs and symptoms, treatment and clinical course of confirmed cases. Design A systematic review and meta-analysis. Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] statement was followed. Methods Electronic databases (Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, and Nature) were searched from 1 December 2020 to 31 May 2021 in the English language using the following keywords alone or in combination: anaphylaxis, non-anaphylaxis, anaphylactic reaction, nonanaphylactic reaction, anaphylactic/anaphylactoid shock, hypersensitivity, allergy reaction, allergic reaction, immunology reaction, immunologic reaction, angioedema, loss of consciousness, generalized erythema, urticaria, urticarial rash, cyanosis, grunting, stridor, tachypnoea, wheezing, tachycardia, abdominal pain, diarrhea, nausea, vomiting and tryptase. We included studies in adults of all ages in all healthcare settings. Effect sizes of prevalence were pooled with 95% confidence intervals (CIs). To minimize heterogeneity, we performed sub-group analyses. Results Of the 1,734 papers that were identified, 26 articles were included in the systematic review (8 case report, 5 cohort, 4 case series, 2 randomized controlled trial and 1 randomized cross-sectional studies) and 14 articles (1 cohort, 2 case series, 1 randomized controlled trial and 1 randomized cross-sectional studies) were included in meta-analysis. Studies involving 26,337,421 vaccine recipients [Pfizer-BioNTech (n = 14,505,399) and Moderna (n = 11,831,488)] were analyzed. The overall pooled prevalence estimate of anaphylaxis to both vaccines was 5.0 (95% CI 2.9 to 7.2, I2 = 81%, p = < 0.0001), while the overall pooled prevalence estimate of nonanaphylactic reactions to both vaccines was 53.9 (95% CI 0.0 to 116.1, I2 = 99%, p = < 0.0001). Vaccination with Pfizer-BioNTech resulted in higher anaphylactic reactions compared to Moderna (8.0, 95% CI 0.0 to 11.3, I2 = 85% versus 2.8, 95% CI 0.0 to 5.7, I2 = 59%). However, lower incidence of nonanaphylactic reactions was associated with Pfizer-BioNTech compared to Moderna (43.9, 95% CI 0.0 to 131.9, I2 = 99% versus 63.8, 95% CI 0.0 to 151.8, I2 = 98%). The funnel plots for possible publication bias for the pooled effect sizes to determine the incidence of anaphylaxis and nonanaphylactic reactions associated with mRNA COVID-19 immunization based on mRNA vaccine type appeared asymmetrical on visual inspection, and Egger’s tests confirmed asymmetry by producing p values < 0.05. Across the included studies, the most commonly identified risk factors for anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines were female sex and personal history of atopy. The key triggers to anaphylactic and nonanaphylactic reactions identified in these studies included foods, medications, stinging insects or jellyfish, contrast media, cosmetics and detergents, household products, and latex. Previous history of anaphylaxis; and comorbidities such as asthma, allergic rhinitis, atopic and contact eczema/dermatitis and psoriasis and cholinergic urticaria were also found to be important. Conclusion The prevalence of COVID-19 mRNA vaccine-associated anaphylaxis is very low; and nonanaphylactic reactions occur at higher rate, however, cutaneous reactions are largely self-limited. Both anaphylactic and nonanaphylactic reactions should not discourage vaccination.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

Alhumaid

Mutair

Alawi

et al. 2021

Allergy Asthma Clin Immunol

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show abstract

“… 15 Anaphylaxis has been reported, at a rate of 4.7 cases/million doses, following BNT162b2 vaccination, and PEG has been identified as a candidate allergen. 16 , 17 , 18 , 19 Prevaccination screening questionnaires, if aligned with World Health Organization recommendations, advise enquiring about PEG allergy. 20 , 21…”

Section: Introductionmentioning

confidence: 99%

Safety of administration of BNT162b2 mRNA (Pfizer‐BioNTech) COVID‐19 vaccine in youths and young adults with a history of acute lymphoblastic leukemia and allergy to PEG‐asparaginase

Mark

Gupta

Punnett

et al. 2021

Pediatric Blood & Cancer

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Vaccinationis a critical tool in the prevention of COVID‐19 infection for individuals and for communities. The mRNA vaccines contain polyethylene glycol (PEG) as a stabilizer. Currently, in North America, only the BNT162b2 (Pfizer‐BioNTech ) mRNA vaccine is approved for individuals aged 12–17. Most patients treated with contemporary regimens for acute lymphoblastic leukemia receive PEG‐asparaginase (PEG‐ASNase) and 10%–30% will develop allergic reactions. Optimizing access and safety for vaccine administration for these patients is critical. This report describes a process developed to support COVID vaccination in a cohort of adolescents and young adults with a history of PEG‐ASNase allergy.

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A systemic review and recommendation for an autopsy approach to death followed the COVID 19 vaccination

Tan

Koh²,

Lai³

et al. 2022

Forensic Science International

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Skin testing with Pfizer SARS-CoV-2 vaccine and PEG 2000

Cited by 11 publications

References 5 publications

Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

Anaphylactic and nonanaphylactic reactions to SARS-CoV-2 vaccines: a systematic review and meta-analysis

Safety of administration of BNT162b2 mRNA (Pfizer‐BioNTech) COVID‐19 vaccine in youths and young adults with a history of acute lymphoblastic leukemia and allergy to PEG‐asparaginase

A systemic review and recommendation for an autopsy approach to death followed the COVID 19 vaccination

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