TY - JOUR

T1 - Allergies and COVID-19 vaccines

T2 - An ENDA/EAACI Position paper

AU - Barbaud, Annick

AU - Garvey, Lene Heise

AU - Arcolaci, Alessandra

AU - Brockow, Knut

AU - Mori, Francesca

AU - Mayorga, Cristobalina

AU - Bonadonna, Patrizia

AU - Atanaskovic-Markovic, Marina

AU - Moral, Luis

AU - Zanoni, Giovanna

AU - Pagani, Mauro

AU - Soria, Angèle

AU - Jošt, Maja

AU - Caubet, Jean-Christoph

AU - Carmo, Abreu

AU - Mona, Al Ahmad

AU - Alvarez-Perea, Alberto

AU - Bavbek, Sevim

AU - Benedetta, Biagioni

AU - Bilo, M Beatrice

AU - Blanca-López, Natalia

AU - Bogas, Herrera Gádor

AU - Buonomo, Alessandro

AU - Calogiuri, Gianfranco

AU - Carli, Giulia

AU - Cernadas, Josefina

AU - Cortellini, Gabriele

AU - Celik, Gülfem

AU - Demir, Semra

AU - Doña, Inmaculada

AU - Dursun, Adile Berna

AU - Eberlein, Bernadette

AU - Faria, Emilia

AU - Fernandes, Bryan

AU - Garcez, Tomaz

AU - Garcia-Nunez, Ignacio

AU - Gawlik, Radoslaw

AU - Gelincik, Asli

AU - Gomes, Eva

AU - Gooi, Jimmy H. C.

AU - Grosber, Martine

AU - Gülen, Theo

AU - Hacard, Florence

AU - Hoarau, Cyrille

AU - Janson, Christer

AU - Johnston, Sebastian L

AU - Joerg, Lukas

AU - Kepil Özdemir, Seçil

AU - Klimek, Ludger

AU - Košnik, Mitja

AU - Kowalski, Marek L

AU - Kuyucu, Semanur

AU - Kvedariene, Violeta

AU - Laguna, Jose Julio

AU - Lombardo, Carla

AU - Marinho, Susana

AU - Merk, Hans

AU - Meucci, Elisa

AU - Morisset, Martine

AU - Munoz-Cano, Rosa

AU - Murzilli, Francesco

AU - Nakonechna, Alla

AU - Popescu, Florin Dan

AU - Porebski, Grzegorz

AU - Radice, Anna

AU - Regateiro, Frederico S.

AU - Röckmann, Heike

AU - Romano, Antonino

AU - Sargur, Ravishankar

AU - Sastre, Joaquin

AU - Hofmeier, Kathrin Scherer

AU - Sedláčková, Lenka

AU - Sobotkova, Marta

AU - Terreehorst, Ingrid

AU - Treudler, Regina

AU - Walusiak-Skorupa, Jolanta

AU - Wedi, Bettina

AU - Wöhrl, Stefan

AU - Zidarn, Mihael

AU - Zuberbier, Torsten

AU - Agache, Ioana

AU - Torres, Maria J.

N1 - Publisher Copyright: © 2022 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

PY - 2022

Y1 - 2022

N2 - 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.

AB - 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.

KW - allergy test

KW - anaphylaxis

KW - COVID-19 vaccine

KW - mRNA vaccines

KW - risk assessment

U2 - 10.1111/all.15241

DO - 10.1111/all.15241

M3 - Journal article

C2 - 35112371

AN - SCOPUS:85126057228

VL - 77

SP - 2292

EP - 2312

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

SN - 0105-4538

IS - 8

ER -