Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper

Annick Barbaud; Lene Heise Garvey; Alessandra Arcolaci; Knut Brockow; Francesca Mori; Cristobalina Mayorga; Patrizia Bonadonna; Marina Atanaskovic-Markovic; Luis Moral; Giovanna Zanoni; Mauro Pagani; Angèle Soria; Maja Jošt; Jean-Christoph Caubet; Abreu Carmo; Al-Ahmad Mona; Alberto Alvarez-Perea; Sevim Bavbek; Biagioni Benedetta; M. Beatrice Bilo; Natalia Blanca-López; Herrera G. dor Bogas; Alessandro Buonomo; Gianfranco Calogiuri; Giulia Carli; Josefina Cernadas; Gabriele Cortellini; G. lfem Celik; Semra Demir; Inmaculada Doña; Adile Berna Dursun; Bernadette Eberlein; Emilia Faria; Bryan Fernandes; Tomaz Garcez; Ignacio Garcia-Nunez; Radoslaw Gawlik; Asli Gelincik; Eva Gomes; Jimmy H. C. Gooi; Martine Grosber; Theo Gülen; Florence Hacard; Cyrille Hoarau; Christer Janson; Sebastian L. Johnston; Lukas Joerg; Seçil Kepil Özdemir; Ludger Klimek; Mitja Košnik; Marek L. Kowalski; Semanur Kuyucu; Violeta Kvedariene; Jose Julio Laguna; Carla Lombardo; Susana Marinho; Hans Merk; Elisa Meucci; Martine Morisset; Rosa Munoz-Cano; Francesco Murzilli; Alla Nakonechna; Florin-Dan Popescu; Grzegorz Porebski; Anna Radice; Frederico S. Regateiro; Heike Röckmann; Antonino Romano; Ravishankar Sargur; Joaquin Sastre; Kathrin Scherer Hofmeier; Lenka Sedláčková; Marta Sobotkova; Ingrid Terreehorst; Regina Treudler; Jolanta Walusiak-Skorupa; Bettina Wedi; Stefan Wöhrl; Mihael Zidarn; Torsten Zuberbier; Ioana Agache; Maria J. Torres

doi:https://doi.org/10.1111/all.15241

Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper

Annick Barbaud, Lene Heise Garvey, Alessandra Arcolaci, Knut Brockow, Francesca Mori, Cristobalina Mayorga, Patrizia Bonadonna, Marina Atanaskovic-Markovic, Luis Moral, Giovanna Zanoni, Mauro Pagani, Angèle Soria, Maja Jošt, Jean-Christoph Caubet, Abreu Carmo, Al-Ahmad Mona, Alberto Alvarez-Perea, Sevim Bavbek, Biagioni Benedetta, M. Beatrice BiloNatalia Blanca-López, Herrera G. dor Bogas, Alessandro Buonomo, Gianfranco Calogiuri, Giulia Carli, Josefina Cernadas, Gabriele Cortellini, G. lfem Celik, Semra Demir, Inmaculada Doña, Adile Berna Dursun, Bernadette Eberlein, Emilia Faria, Bryan Fernandes, Tomaz Garcez, Ignacio Garcia-Nunez, Radoslaw Gawlik, Asli Gelincik, Eva Gomes, Jimmy H. C. Gooi, Martine Grosber, Theo Gülen, Florence Hacard, Cyrille Hoarau, Christer Janson, Sebastian L. Johnston, Lukas Joerg, Seçil Kepil Özdemir, Ludger Klimek, Mitja Košnik, Marek L. Kowalski, Semanur Kuyucu, Violeta Kvedariene, Jose Julio Laguna, Carla Lombardo, Susana Marinho, Hans Merk, Elisa Meucci, Martine Morisset, Rosa Munoz-Cano, Francesco Murzilli, Alla Nakonechna, Florin-Dan Popescu, Grzegorz Porebski, Anna Radice, Frederico S. Regateiro, Heike Röckmann, Antonino Romano, Ravishankar Sargur, Joaquin Sastre, Kathrin Scherer Hofmeier, Lenka Sedláčková, Marta Sobotkova, Ingrid Terreehorst, Regina Treudler, Jolanta Walusiak-Skorupa, Bettina Wedi, Stefan Wöhrl, Mihael Zidarn, Torsten Zuberbier, Ioana Agache, Maria J. Torres

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

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.

Original language	English
Pages (from-to)	2292-2312
Number of pages	21
Journal	Allergy: European Journal of Allergy and Clinical Immunology
Volume	77
Issue number	8
Early online date	2022
DOIs	https://doi.org/10.1111/all.15241
Publication status	Published - Aug 2022

Keywords

COVID-19 vaccine
allergy test
anaphylaxis
mRNA vaccines
risk assessment

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https://doi.org/10.1111/all.15241

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Barbaud, A., Garvey, L. H., Arcolaci, A., Brockow, K., Mori, F., Mayorga, C., Bonadonna, P., Atanaskovic-Markovic, M., Moral, L., Zanoni, G., Pagani, M., Soria, A., Jošt, M., Caubet, J.-C., Carmo, A., Mona, A.-A., Alvarez-Perea, A., Bavbek, S., Benedetta, B., ... Torres, M. J. (2022). Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper. Allergy: European Journal of Allergy and Clinical Immunology, 77(8), 2292-2312. https://doi.org/10.1111/all.15241

@article{3dd5dedc903d4f86892bb9f2f87ecb1f,

title = "Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper",

abstract = "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.",

keywords = "COVID-19 vaccine, allergy test, anaphylaxis, mRNA vaccines, risk assessment",

author = "Annick Barbaud and Garvey, {Lene Heise} and Alessandra Arcolaci and Knut Brockow and Francesca Mori and Cristobalina Mayorga and Patrizia Bonadonna and Marina Atanaskovic-Markovic and Luis Moral and Giovanna Zanoni and Mauro Pagani and Ang{\`e}le Soria and Maja Jo{\v s}t and Jean-Christoph Caubet and Abreu Carmo and Al-Ahmad Mona and Alberto Alvarez-Perea and Sevim Bavbek and Biagioni Benedetta and Bilo, {M. Beatrice} and Natalia Blanca-L{\'o}pez and Bogas, {Herrera G. dor} and Alessandro Buonomo and Gianfranco Calogiuri and Giulia Carli and Josefina Cernadas and Gabriele Cortellini and Celik, {G. lfem} and Semra Demir and Inmaculada Do{\~n}a and Dursun, {Adile Berna} and Bernadette Eberlein and Emilia Faria and Bryan Fernandes and Tomaz Garcez and Ignacio Garcia-Nunez and Radoslaw Gawlik and Asli Gelincik and Eva Gomes and Gooi, {Jimmy H. C.} and Martine Grosber and Theo G{\"u}len and Florence Hacard and Cyrille Hoarau and Christer Janson and Johnston, {Sebastian L.} and Lukas Joerg and {Kepil {\"O}zdemir}, Se{\c c}il and Ludger Klimek and Mitja Ko{\v s}nik and Kowalski, {Marek L.} and Semanur Kuyucu and Violeta Kvedariene and Laguna, {Jose Julio} and Carla Lombardo and Susana Marinho and Hans Merk and Elisa Meucci and Martine Morisset and Rosa Munoz-Cano and Francesco Murzilli and Alla Nakonechna and Florin-Dan Popescu and Grzegorz Porebski and Anna Radice and Regateiro, {Frederico S.} and Heike R{\"o}ckmann and Antonino Romano and Ravishankar Sargur and Joaquin Sastre and {Scherer Hofmeier}, Kathrin and Lenka Sedl{\'a}{\v c}kov{\'a} and Marta Sobotkova and Ingrid Terreehorst and Regina Treudler and Jolanta Walusiak-Skorupa and Bettina Wedi and Stefan W{\"o}hrl and Mihael Zidarn and Torsten Zuberbier and Ioana Agache and Torres, {Maria J.}",

note = "Publisher Copyright: {\textcopyright} 2022 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.",

year = "2022",

month = aug,

doi = "https://doi.org/10.1111/all.15241",

language = "English",

volume = "77",

pages = "2292--2312",

journal = "Allergy: European Journal of Allergy and Clinical Immunology",

issn = "0105-4538",

publisher = "Wiley-Blackwell",

number = "8",

}

Barbaud, A, Garvey, LH, Arcolaci, A, Brockow, K, Mori, F, Mayorga, C, Bonadonna, P, Atanaskovic-Markovic, M, Moral, L, Zanoni, G, Pagani, M, Soria, A, Jošt, M, Caubet, J-C, Carmo, A, Mona, A-A, Alvarez-Perea, A, Bavbek, S, Benedetta, B, Bilo, MB, Blanca-López, N, Bogas, HGD, Buonomo, A, Calogiuri, G, Carli, G, Cernadas, J, Cortellini, G, Celik, GL, Demir, S, Doña, I, Dursun, AB, Eberlein, B, Faria, E, Fernandes, B, Garcez, T, Garcia-Nunez, I, Gawlik, R, Gelincik, A, Gomes, E, Gooi, JHC, Grosber, M, Gülen, T, Hacard, F, Hoarau, C, Janson, C, Johnston, SL, Joerg, L, Kepil Özdemir, S, Klimek, L, Košnik, M, Kowalski, ML, Kuyucu, S, Kvedariene, V, Laguna, JJ, Lombardo, C, Marinho, S, Merk, H, Meucci, E, Morisset, M, Munoz-Cano, R, Murzilli, F, Nakonechna, A, Popescu, F-D, Porebski, G, Radice, A, Regateiro, FS, Röckmann, H, Romano, A, Sargur, R, Sastre, J, Scherer Hofmeier, K, Sedláčková, L, Sobotkova, M, Terreehorst, I, Treudler, R, Walusiak-Skorupa, J, Wedi, B, Wöhrl, S, Zidarn, M, Zuberbier, T, Agache, I & Torres, MJ 2022, 'Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper', Allergy: European Journal of Allergy and Clinical Immunology, vol. 77, no. 8, pp. 2292-2312. https://doi.org/10.1111/all.15241

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 G. dor

AU - Buonomo, Alessandro

AU - Calogiuri, Gianfranco

AU - Carli, Giulia

AU - Cernadas, Josefina

AU - Cortellini, Gabriele

AU - Celik, G. lfem

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 - Scherer Hofmeier, Kathrin

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.

PY - 2022/8

Y1 - 2022/8

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 - COVID-19 vaccine

KW - allergy test

KW - anaphylaxis

KW - mRNA vaccines

KW - risk assessment

UR - http://www.scopus.com/inward/record.url?scp=85126057228&partnerID=8YFLogxK

U2 - https://doi.org/10.1111/all.15241

DO - https://doi.org/10.1111/all.15241

M3 - Article

C2 - 35112371

SN - 0105-4538

VL - 77

SP - 2292

EP - 2312

JO - Allergy: European Journal of Allergy and Clinical Immunology

JF - Allergy: European Journal of Allergy and Clinical Immunology

IS - 8

ER -

Allergies and COVID-19 vaccines: An ENDA/EAACI Position paper

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