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Successful SARS-CoV-2 vaccine allergy risk-management: The experience of a large Italian University Hospital()

BACKGROUND: Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been approved recently, and public concern regarding the risk of anaphylactic reactions arose after a few cases during the first days of mass vaccination. Polyethylene glycol (PEG) has been suggested as the...

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Detalles Bibliográficos
Autores principales: Paoletti, Giovanni, Racca, Francesca, Piona, Alessandra, Melone, Giulio, Merigo, Morena, Puggioni, Francesca, Ferri, Sebastian, Azzolini, Elena, Lagioia, Michele, Lamacchia, Donatella, Cataldo, Giuseppe, Cecconi, Maurizio, Canonica, Giorgio Walter, Heffler, Enrico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: World Allergy Organization 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8030995/
https://www.ncbi.nlm.nih.gov/pubmed/33850601
http://dx.doi.org/10.1016/j.waojou.2021.100541
Descripción
Sumario:BACKGROUND: Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) vaccines have been approved recently, and public concern regarding the risk of anaphylactic reactions arose after a 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.