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Rapid progress in our understanding of COVID-19 vaccine allergy: A cause for optimism, not hesitancy - 05/07/22

Doi : 10.1016/j.jaci.2022.03.023 
Aleena Banerji, MD a, b, , Allison E. Norton, MD c, Kimberly G. Blumenthal, MD, MSc a, b, d, Cosby A. Stone, MD, MPH e, Elizabeth Phillips, MD e
a Division of Rheumatology Allergy and Immunology, Department of Medicine, Massachusetts General Hospital, Boston, Mass 
b Harvard Medical School, Boston, Mass 
c Division of Pediatric Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital, Vanderbilt University Medical Center, Nashville, Tenn 
d Edward P. Lawrence Center for Quality and Safety, Massachusetts General Hospital, Boston, Mass 
e Department of Medicine, Vanderbilt University Medical Center, Nashville, Tenn 

Corresponding author: Aleena Banerji, MD, Massachusetts General Hospital, Department of Medicine, Division of Rheumatology, Allergy, and Immunology.Massachusetts General HospitalDepartment of MedicineDivision of RheumatologyAllergy, and Immunology

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Abstract

Anaphylaxis is a life-threatening condition and when associated with vaccination, leads to vaccine hesitancy. The concerns around vaccine-related anaphylaxis have become even more important during the coronavirus disease 2019 (COVID-19) pandemic where the COVID-19 vaccines remain one of our most important tools. Although rates of anaphylaxis to COVID-19 vaccines are not significantly different from those to other vaccines, Centers for Disease Control and Prevention guidance recommends avoidance of the same COVID-19 vaccine in individuals who had an allergic reaction or are allergic to a COVID-19 vaccine component. Fortunately, our understanding of COVID-19 vaccine allergic reactions has improved dramatically in the past year in large part due to important research efforts from individuals in the allergy community. Initially, researchers published algorithmic approaches using risk stratification and excipient skin testing. However, as our experience and knowledge improved with ongoing research, we have better data showing safety of repeat vaccination despite an initial reaction. We review our progress starting in December 2020 when the Food and Drug Administration approved the first COVID-19 vaccine in the United States through early 2022, highlighting our success in understanding COVID-19 vaccine reactions.

El texto completo de este artículo está disponible en PDF.

Key words : COVID-19, vaccine, allergy, anaphylaxis, polyethylene glycol, mRNA

Abbreviations used : COVID-19, mRNA, PEG


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 E.P. is funded by grants from the National Institutes of Health (NIH) (grant nos. R01HG010863, R01AI152183, U01AI154659, R13AR078623, and UAI109565) and the National Health and Medical Research Council of Australia. K.G.B. is funded by grants from the NIH/National Institute of Allergy and Infectious Diseases (grant nos. K01 AI125631 and R01 AI150295), Agency for Healthcare Research and Quality (grant no. R01HS025375), MGH Executive Committee on Research, MGH Department of Medicine (DOM) Transformative Scholar Award, and MGH DOM COVID-19 Junior Investigator Support Initiative. C.A.S. is funded by the American Academy of Audiology, Asthma & Immunology Foundation via a Faculty Development Award.
 Disclosure of potential conflict of interest: A. E. Norton reports working as subject matter expert for the Clinical Immunization Safety Assessment project sponsored by the Centers for Disease Control and Prevention. The rest of the authors declare that they have no relevant conflicts of interest.


© 2022  American Academy of Allergy, Asthma & Immunology. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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