tetano
Editor, Senior Moderator
World Allergy Organ J
. 2021 Apr 8;100541.
doi: 10.1016/j.waojou.2021.100541. Online ahead of print.
Successful SARS-CoV-2 vaccine allergy risk-management: the experience of a large Italian University Hospital
Giovanni Paoletti[SUP] 1 2 [/SUP], Francesca Racca[SUP] 1 [/SUP], Alessandra Piona[SUP] 3 [/SUP], Giulio Melone[SUP] 1 [/SUP], Morena Merigo[SUP] 1 [/SUP], Francesca Puggioni[SUP] 1 2 [/SUP], Sebastian Ferri[SUP] 1 2 [/SUP], Elena Azzolini[SUP] 4 [/SUP], Michele Lagioia[SUP] 4 [/SUP], Donatella Lamacchia[SUP] 1 [/SUP], Giuseppe Cataldo[SUP] 1 [/SUP], Maurizio Cecconi[SUP] 2 5 [/SUP], Giorgio Walter Canonica[SUP] 1 2 [/SUP], Enrico Heffler[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been recently approved, and public concern regarding the risk of anaphylactic reactions arised after few cases during the first days of mass-vaccination. Polyethylene glycol (PEG) has been suggested as the most probable culprit agent for allergic reactions.
Objective: We describe the allergy work-up protocol implemented for the vaccination campaign in our Center, aiming to allow the greatest number of people to be vaccinated safely.
Methods: the protocol included the self-report of a history of suspected drug or vaccine allergies, and subsequent teleconsultation and allergometric tests for PEG and Polysorbate 80 (PS80). A desensitizing protocol of vaccine administration was applied to patients sensitized only to PS80, and to those with a suspect allergic reaction after the first vaccine dose.
Results: 10.2% (414 out of 4042) of the entire vaccine population have been screened: only one patient resulted allergic to PEG and therefore excluded from the vaccination. Another patient was sensitized to PS80 only and safely vaccinated applying the desensitizing protocol. Seven subjects without a previous history of allergic disease experienced suspect hypersensitivity reactions to the first administered dose: one of them resulted allergic to PEG and was excluded from the second dose, while the others safely completed the vaccination with the desensitizing protocol.
Conclusion: a careful allergological risk-assessment protocol significantly reduces the number of patients who would have avoided SARS-CoV-2 vaccination for their allergies and to effectively identify and manage those rare patients with sensitization to PEGs and/or PS80.
Keywords: AAIITO, Italian Territorial and Hospital Allergologists and Immunologists Association; Allergy; Anaphylaxis; CDC, Center for Diseases Control; COVID-19; COVID-19, Coronavirus-Disease-2019; DMG, Dimyristoyl glycerol; DPT, Diphteria Pertussis Tetanus; FDA, Food and Drug Administration; PEG, Polyethylene glycol; PS80, Polysorbate 80; Polyethylen glycole; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; SIAAIC, Italian Society of Allergology Asthma and Clinical Immunology; Vaccine.
. 2021 Apr 8;100541.
doi: 10.1016/j.waojou.2021.100541. Online ahead of print.
Successful SARS-CoV-2 vaccine allergy risk-management: the experience of a large Italian University Hospital
Giovanni Paoletti[SUP] 1 2 [/SUP], Francesca Racca[SUP] 1 [/SUP], Alessandra Piona[SUP] 3 [/SUP], Giulio Melone[SUP] 1 [/SUP], Morena Merigo[SUP] 1 [/SUP], Francesca Puggioni[SUP] 1 2 [/SUP], Sebastian Ferri[SUP] 1 2 [/SUP], Elena Azzolini[SUP] 4 [/SUP], Michele Lagioia[SUP] 4 [/SUP], Donatella Lamacchia[SUP] 1 [/SUP], Giuseppe Cataldo[SUP] 1 [/SUP], Maurizio Cecconi[SUP] 2 5 [/SUP], Giorgio Walter Canonica[SUP] 1 2 [/SUP], Enrico Heffler[SUP] 1 2 [/SUP]
Affiliations
- PMID: 33850601
- PMCID: PMC8030995
- DOI: 10.1016/j.waojou.2021.100541
Abstract
Background: Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been recently approved, and public concern regarding the risk of anaphylactic reactions arised after few cases during the first days of mass-vaccination. Polyethylene glycol (PEG) has been suggested as the most probable culprit agent for allergic reactions.
Objective: We describe the allergy work-up protocol implemented for the vaccination campaign in our Center, aiming to allow the greatest number of people to be vaccinated safely.
Methods: the protocol included the self-report of a history of suspected drug or vaccine allergies, and subsequent teleconsultation and allergometric tests for PEG and Polysorbate 80 (PS80). A desensitizing protocol of vaccine administration was applied to patients sensitized only to PS80, and to those with a suspect allergic reaction after the first vaccine dose.
Results: 10.2% (414 out of 4042) of the entire vaccine population have been screened: only one patient resulted allergic to PEG and therefore excluded from the vaccination. Another patient was sensitized to PS80 only and safely vaccinated applying the desensitizing protocol. Seven subjects without a previous history of allergic disease experienced suspect hypersensitivity reactions to the first administered dose: one of them resulted allergic to PEG and was excluded from the second dose, while the others safely completed the vaccination with the desensitizing protocol.
Conclusion: a careful allergological risk-assessment protocol significantly reduces the number of patients who would have avoided SARS-CoV-2 vaccination for their allergies and to effectively identify and manage those rare patients with sensitization to PEGs and/or PS80.
Keywords: AAIITO, Italian Territorial and Hospital Allergologists and Immunologists Association; Allergy; Anaphylaxis; CDC, Center for Diseases Control; COVID-19; COVID-19, Coronavirus-Disease-2019; DMG, Dimyristoyl glycerol; DPT, Diphteria Pertussis Tetanus; FDA, Food and Drug Administration; PEG, Polyethylene glycol; PS80, Polysorbate 80; Polyethylen glycole; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; SIAAIC, Italian Society of Allergology Asthma and Clinical Immunology; Vaccine.